Bitantos, Luz L.

HRN: 28-96-30  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/10/2026
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
05/10/2026
05/16/2026
TOPICAL
1% 25gm
BID
Superficial Partial Thickness Burn Anterior Leg
Checking Initial Appropriateness 
05/10/2026
CEFTRIAXONE 1G (VIAL)
05/10/2026
05/16/2026
IV
2gm
Q24
CAP MR
Checking Initial Appropriateness 
05/10/2026
AZITHROMYCIN 500MG TABLET (TAB)
05/10/2026
05/14/2026
PO
500mgtab
Q24
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: