Asdanal, Usban J.

HRN: 28-68-77  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/12/2026
AZITHROMYCIN 500MG TABLET (TAB)
03/12/2026
03/17/2026
PO
500mg
OD
CAP
Checking Initial Appropriateness 
03/12/2026
CEFTRIAXONE 1G (VIAL)
03/12/2026
03/19/2026
IV
2g
OD
Cap
Checking Initial Appropriateness 
03/16/2026
ACICLOVIR 250MG VIAL (I.V. INFUSION)
03/16/2026
03/23/2026
IV
750mg
Od
Pneumonia
Rejected 
03/16/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
03/16/2026
03/23/2026
IV
750mg
Od
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: