Andea, Teofista M.

HRN: 00-67-73  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/03/2026
AZITHROMYCIN 500MG TABLET (TAB)
01/03/2026
01/07/2026
PO
500mg
Od
Cap Mr
Checking Final Appropriateness 
01/03/2026
CEFTRIAXONE 1G (VIAL)
01/03/2026
01/10/2026
IV
2g
Od
Cap Mr
Checking Final Appropriateness 
01/07/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
01/07/2026
01/14/2026
IV
4.5g
Q6h
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: