Miral, Genilyn C.

HRN: 28-13-26  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/30/2025
CEFTAZIDIME 1GM (VIAL)
12/30/2025
01/06/2026
IV
2g
Q8h
CAP MR
Checking Initial Appropriateness 
12/30/2025
AZITHROMYCIN 500MG TABLET (TAB)
12/30/2025
01/04/2026
PO
500mg
OD
CAP MR
Checking Final 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: