Albia, Pacita .

HRN: 29-11-26  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/06/2026
CEFTRIAXONE 1G (VIAL)
06/06/2026
06/12/2026
IV
2G
OD
PNEUMONIA
Checking Initial Appropriateness 
06/06/2026
AZITHROMYCIN 500MG TABLET (TAB)
06/06/2026
06/10/2026
ORAL
500 MG
OD
PNEUMONIA
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: