Albellar, Jenny B.

HRN: 28-32-55  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/24/2025
AZITHROMYCIN 500MG TABLET (TAB)
12/24/2025
12/28/2025
PO
500mg
OD X 5 Days
CAP-MR
Checking Initial Appropriateness 
12/25/2025
CEFUROXIME 500MG (TAB)
12/25/2025
01/01/2026
ORAL
500 Mg/tab
BID
UTI
Checking Initial Appropriateness 
12/26/2025
CEFTRIAXONE 1G (VIAL)
12/26/2025
01/01/2026
IV
2gms
OD
CAP-MR, UTI
Checking Initial Appropriateness 
12/26/2025
AZITHROMYCIN 500MG TABLET (TAB)
12/26/2025
12/30/2025
PO
500mg
BID X 7 Days
CAP-MR
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: