Lumawan, Juan G.

HRN: 22-80-31  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/07/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/07/2026
05/13/2026
IV
4.5 G
Q6
CAP HR
Checking Initial Appropriateness 
05/07/2026
AZITHROMYCIN 500MG TABLET (TAB)
05/07/2026
05/13/2026
OD
500 MG
OD
CAP HR
Rejected 
05/07/2026
AZITHROMYCIN 500MG TABLET (TAB)
05/07/2026
05/12/2026
ORAL
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: