Basalo, Marlon G.

HRN: 28-46-74  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/25/2026
CEFTRIAXONE 1G (VIAL)
01/25/2026
02/01/2026
IVTT
2g
OD
CAP-MR
Checking Initial Appropriateness 
01/25/2026
AZITHROMYCIN 500MG TABLET (TAB)
01/25/2026
01/30/2026
PO
500mg Tab
OD
CAP-MR
Checking Initial Appropriateness 
01/26/2026
CEFTAZIDIME 1GM (VIAL)
01/26/2026
02/02/2026
IVTT
2g
Q8H
CAP-MR
Checking Initial Appropriateness 
02/04/2026
CEFIXIME 200MG (CAP)
02/04/2026
02/11/2026
PO
200 Mg
BID
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: