Hasim, Ibrahim E.

HRN: 28-69-92  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/17/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/17/2026
03/24/2026
IV
4.5
Q8
CAP MR
Rejected 
03/17/2026
AZITHROMYCIN 500MG TABLET (TAB)
03/17/2026
03/24/2026
PO
500
OD
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: