Evangelista, Ron-lyoud F.

HRN: 18-10-78  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/11/2026
CEFTRIAXONE 1G (VIAL)
05/11/2026
05/11/2026
2G
Iv
Now
Uti
Checking Initial Appropriateness 
05/11/2026
CEFTRIAXONE 1G (VIAL)
05/11/2026
05/18/2026
IV
1g
Q12
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: