Baliling, Charmagne .

HRN: 28-15-92  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/27/2025
CEFTRIAXONE 1G (VIAL)
11/27/2025
12/03/2025
IV
2g
Od
Capmr
Waiting Final Action 
11/27/2025
AZITHROMYCIN 500MG TABLET (TAB)
11/27/2025
12/01/2025
PO
500mg
Od
Capmr
Waiting Final Action 
12/06/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
12/06/2025
12/12/2025
IV
4.5
Q8H
CAP MR
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: