Garcia, Chad Alior .

HRN: 28-53-08  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/28/2026
AMPICILLIN 250MG (VIAL)
02/28/2026
03/07/2026
IVTT
195mg
Q12
UTI
Checking Initial Appropriateness 
02/28/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/28/2026
03/07/2026
IVTT
58mg
Q24
UTI
Checking Initial Appropriateness 
03/02/2026
CEFTAZIDIME 1GM (VIAL)
03/02/2026
03/09/2026
IVT
130mg
Q8
Aspiration Pneumonia
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: