Luayon, Teresa B.

HRN: 21-20-50  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/26/2025
CEFTAZIDIME 1GM (VIAL)
09/26/2025
10/02/2025
IVTT
2g
Every 8hrs
CAP-MR
Checking Initial Appropriateness 
09/26/2025
AZITHROMYCIN 500MG TABLET (TAB)
09/26/2025
10/02/2025
ORAL
500mg
Once A Day
CAP-MR
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: