Laurente, Japhet .

HRN: 26-80-45  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/24/2026
CEFUROXIME 750MG (VIAL)
06/24/2026
06/30/2026
IV
230mg
Q8
UTI
Checking Initial Appropriateness 
06/26/2026
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
06/26/2026
07/01/2026
PO
1.7ml
OD
PCAP
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: