Hinaut, Doroteo D.

HRN: 17-21-52  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/30/2026
CEFTRIAXONE 1G (VIAL)
01/30/2026
02/06/2026
IV
2g
OD
CAP MR
Checking Initial Appropriateness 
01/30/2026
AZITHROMYCIN 500MG TABLET (TAB)
01/30/2026
02/03/2026
PO
500
OD
CAP MR
Checking Initial Appropriateness 
02/03/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
02/03/2026
02/10/2026
IV
4.5g
Q6H
CAP MR
Rejected 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: