Dari, Avelino .

HRN: 28-14-98  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/30/2026
CEFTRIAXONE 1G (VIAL)
04/30/2026
05/07/2026
IV
1G
Q12H
PNEUMONIA
Checking Initial Appropriateness 
05/07/2026
AZITHROMYCIN 500MG TABLET (TAB)
05/07/2026
05/12/2026
PO
500mg
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: