Toledo, Flora .

HRN: 23-86-36  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/17/2026
CEFTRIAXONE 1G (VIAL)
03/17/2026
03/24/2026
IV
2g
OD
CAP MR
Remove - Pending Acceptance
03/17/2026
LEVOFLOXACIN 500MG (TAB)
03/17/2026
03/24/2026
PO
500
OD
CAP MR
Remove - Pending Acceptance
03/19/2026
AZITHROMYCIN 500MG TABLET (TAB)
03/19/2026
03/26/2026
PO
500
OD
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: