Palconit, Rodolfo A.

HRN: 24-89-21  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/16/2025
CEFTRIAXONE 1G (VIAL)
11/16/2025
11/23/2025
IV
2g
OD
CAPMR
Waiting Final Action 
11/16/2025
AZITHROMYCIN 500MG TABLET (TAB)
11/16/2025
11/20/2025
PO
500mg
OD
CAPMR
Waiting Final Action 
11/24/2025
LEVOFLOXACIN 500MG (TAB)
11/24/2025
12/01/2025
PO
500mg
OD
CAPMR
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: