Espadilla, Cerilo R.

HRN: 24-14-29  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/12/2026
CEFTRIAXONE 1G (VIAL)
06/12/2026
06/18/2026
IV
2G
OD
CAP-MR
Remove - Pending Acceptance
06/12/2026
AZITHROMYCIN 500MG TABLET (TAB)
06/12/2026
06/16/2026
PO
500MG
OD
CAP-MR
Remove - Pending Acceptance
06/13/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
06/13/2026
06/20/2026
IV
4.5grams
Q6
Cap-hr
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: