Midjan, Nedzpar M.

HRN: 27-69-04  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/28/2025
CEFTRIAXONE 1G (VIAL)
09/28/2025
10/05/2025
IV
2gms
Q24
PCAP C; Presumptive PTB
Remove - Pending Acceptance
09/28/2025
CEFTRIAXONE 1G (VIAL)
09/28/2025
10/05/2025
IV
2g
Q12H
PCAP C; Presumptive PTB
Remove - Pending Acceptance
10/04/2025
AZITHROMYCIN 500MG TABLET (TAB)
10/04/2025
10/08/2025
PO
1 Tablet
OD
Presumptive PTB
Checking Initial Appropriateness 
10/04/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
10/04/2025
10/11/2025
IV
2g
Q6hours
Presumptive PTB
Checking Initial Appropriateness 

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: