Agot, Alejandra S.

HRN: 27-82-71  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/24/2025
CEFTRIAXONE 1G (VIAL)
12/24/2025
12/30/2025
IV
2 Grams
OD
Cap Mr
Checking Initial Appropriateness 
12/24/2025
AZITHROMYCIN 500MG TABLET (TAB)
12/24/2025
12/28/2025
PO
500 Mg
OD
Cap Mr
Checking Initial Appropriateness 
12/24/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
12/24/2025
12/31/2025
IV
3.375g
Q8
PNEUMONIA
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: