Torres, Quirino C.

HRN: 29-33-51  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/19/2026
CEFTRIAXONE 1G (VIAL)
07/19/2026
07/25/2026
IV
2g
Od
Cap Mr
Checking Final Appropriateness 
07/19/2026
AZITHROMYCIN 500MG TABLET (TAB)
07/19/2026
07/24/2026
IV
500mg
Od
Cap Mr
Checking Final 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: