Bugao, Lita L.

HRN: 02-15-26  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/04/2026
CEFTRIAXONE 1G (VIAL)
01/04/2026
01/10/2026
IV
2 Grams
OD
CAP MR
Checking Final Appropriateness 
01/04/2026
AZITHROMYCIN 500MG TABLET (TAB)
01/04/2026
01/08/2026
PO
500
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: