Antiola, Mark A.

HRN: 27-85-87  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/27/2025
CEFTRIAXONE 1G (VIAL)
09/27/2025
10/04/2025
IV
2g
Q24
Capmr
Checking Initial Appropriateness 
09/27/2025
AZITHROMYCIN 500MG TABLET (TAB)
09/27/2025
10/01/2025
PO
500mg
OD
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: