Manuel, Manuel V.

HRN: 28-13-91  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/21/2025
CEFTAZIDIME 1GM (VIAL)
11/21/2025
11/27/2025
IV
1g
Q8h
CAP-MR
Checking Initial Appropriateness 
11/21/2025
AZITHROMYCIN 500MG TABLET (TAB)
11/21/2025
11/27/2025
PO
500mg
Od
CAP-MR
Checking Initial Appropriateness 
11/25/2025
RIFAXIMIN 200MG (TAB)
11/25/2025
12/02/2025
PO
500
TID
Ascites
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: