Rolida, Chriciel B.

HRN: 28-55-79  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/07/2026
CEFALEXIN 500MG CAP
05/07/2026
05/13/2026
ORAL
500mg
BID
UTI
Checking Final Appropriateness 
05/07/2026
CEFUROXIME 500MG (TAB)
05/07/2026
05/13/2026
ORAL
500mg
BID
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: