Maglinte, Rico G.

HRN: 23-55-55  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/19/2026
CEFTRIAXONE 1G (VIAL)
05/19/2026
05/25/2026
IV
2GM
OD
CAP MR
Checking Initial Appropriateness 
05/19/2026
AZITHROMYCIN 500MG TABLET (TAB)
05/19/2026
05/23/2026
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: