Enggid, Felipe T.

HRN: 28-21-69  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/05/2025
AZITHROMYCIN 500MG TABLET (TAB)
12/05/2025
12/09/2025
PO
500mg
OD
CAP-HR
Checking Initial Appropriateness 
12/05/2025
CEFTRIAXONE 1G (VIAL)
12/05/2025
12/11/2025
IV
2gm
OD
CAP-HR
Checking Initial Appropriateness 
12/06/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
12/06/2025
12/13/2025
IV
4.5g
Q8h
CAP-HR
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: