Bercide, Samuel .

HRN: 26-72-25  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/01/2026
CEFTRIAXONE 1G (VIAL)
08/01/2026
08/07/2026
IVTT
2g
OD
Cap-MR
Remove - Pending Acceptance
08/01/2026
AZITHROMYCIN 500MG TABLET (TAB)
08/01/2026
08/05/2026
PO
500 Mg/tab, 1 Tab
OD
Cap-MR
Remove - Pending Acceptance
08/04/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
08/04/2026
08/10/2026
IV
4.5gms
Q6h
CAP HR
Remove - Pending Acceptance

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: