Tamparong, Bernabe, Jr. P.

HRN: 18-32-79  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/11/2026
CEFTAZIDIME 1GM (VIAL)
01/11/2026
01/18/2026
IV
1g
Q8H
CAP MR
Checking Initial Appropriateness 
01/12/2026
CEFTAZIDIME 1GM (VIAL)
01/12/2026
01/19/2026
IV
1g
Q48 Post HD
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: