Langharan, Perlita M.

HRN: 27-82-31  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/19/2025
CEFTRIAXONE 1G (VIAL)
09/19/2025
09/26/2025
IV
2g
OD
Capmr
Checking Initial Appropriateness 
09/19/2025
AZITHROMYCIN 500MG TABLET (TAB)
09/19/2025
09/26/2025
PO
500mg
Od
Capmr
Checking Initial Appropriateness 
09/21/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
09/21/2025
09/28/2025
IVTT
4.5g
Q8H
CAPMR
Rejected 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: