Ariza, Ermelinda C.

HRN: 28-21-72  Sex: Female

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-mr
Checking Initial Appropriateness 
12/05/2025
CEFTRIAXONE 1G (VIAL)
12/05/2025
12/11/2025
IV
2g
OD
Cap-MR
Checking Initial Appropriateness 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: