Talledo, Jerma M.

HRN: 11-64-06  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/04/2026
CEFTRIAXONE 1G (VIAL)
07/04/2026
07/11/2026
IV
2g
OD
UTI, CAP MR
Checking Initial Appropriateness 
07/04/2026
AZITHROMYCIN 500MG TABLET (TAB)
07/04/2026
07/09/2026
ORAL
500mg
OD
CAP-MR
Checking Initial Appropriateness 
07/05/2026
AMOXICILLIN 500MG CAPSULE (CAP)
07/05/2026
07/19/2026
PO
1g
Bid
H. Pylori
Checking Initial Appropriateness 
07/05/2026
CLARITHROMYCIN 500MG (CAP)
07/05/2026
07/19/2026
PO
500mg
Bid
H. Pylori
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: