Tizon, Candido T.

HRN: 14-84-09  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/13/2022
CEFTRIAXONE 1G (VIAL)
09/13/2022
09/19/2022
IV
2gm
OD
CAP MR
Waiting Final Action 
03/17/2024
AZITHROMYCIN 500MG TABLET (TAB)
03/13/2024
03/19/2024
PO
500mg
OD
CAP
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: