Rose, Repollo M.

HRN: 21-06-25  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/05/2022
CEFUROXIME 500MG (TAB)
04/05/2022
04/12/2022
PO
500MG
BID
UTI
Waiting Final Action 
04/08/2022
AZITHROMYCIN 500MG TABLET (TAB)
04/08/2022
04/11/2022
PO
500MG
OD
CAP-LR
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: