Dingal, Marcela .

HRN: 29-29-80  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/14/2026
CEFTRIAXONE 1G (VIAL)
07/14/2026
07/21/2026
IV
2g
Q24
Cap MR
Checking Initial Appropriateness 
07/14/2026
AZITHROMYCIN 500MG TABLET (TAB)
07/14/2026
07/19/2026
ORAL
500
OD
Cap MR
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: