Paculba, Benigno .

HRN: 14-24-09  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/15/2025
CEFTRIAXONE 1G (VIAL)
10/15/2025
10/22/2025
IV
2G
OD
CAP MR
Waiting Final Action 
10/15/2025
AZITHROMYCIN 500MG TABLET (TAB)
10/15/2025
10/19/2025
PO
500mg
Od
CAP MR
Waiting Final Action 
10/18/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/18/2025
10/25/2025
IV
3.375g
Q8
CAPHR
Waiting Final Action 

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: