Bucol, Jimmy Y.

HRN: 13-50-98  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/27/2026
CEFTRIAXONE 1G (VIAL)
04/27/2026
05/04/2026
IV
2G
OD
Pneumonia
Checking Initial Appropriateness 
04/27/2026
AZITHROMYCIN 500MG TABLET (TAB)
04/27/2026
05/01/2026
PO
500MG
OD
Pneumonia
Checking Initial Appropriateness 
04/29/2026
CIPROFLOXACIN 500MG (TAB)
04/29/2026
05/06/2026
ORAL
500mg
BID
UTI
Checking Initial Appropriateness 
04/30/2026
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
04/30/2026
05/07/2026
TOPICAL
1%
BID
Ulcer
Checking Initial Appropriateness 
05/01/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/01/2026
05/08/2026
IV
4.5g
Now Then Q8
COMPLICATED UTI
Checking Initial Appropriateness 
05/01/2026
CIPROFLOXACIN 500MG (TAB)
05/01/2026
05/07/2026
PO
500mg
BID
COMPLICATED UTI
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: