Pangulima, Esnia E.

HRN: 12-02-46  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/16/2025
CEFTRIAXONE 1G (VIAL)
10/16/2025
10/23/2025
IVTT
2g
OD
CAP-MR
Waiting Final Action 
10/16/2025
AZITHROMYCIN 500MG TABLET (TAB)
10/16/2025
10/21/2025
PO
500mg
OD
CAP-MR
Waiting Final Action 
10/23/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/23/2025
10/30/2025
IV
4.5g
Q8H
CAPMR
Checking Final 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: