Alesna, Fe B.

HRN: 21-32-72  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/16/2022
CEFUROXIME 1.5GM (VIAL)
05/16/2022
05/22/2022
IV
1.5gm
TID
CAP MR
Waiting Final Action 
05/16/2022
AZITHROMYCIN 500MG TABLET (TAB)
05/16/2022
05/20/2022
PO
500mg
OD
CAP MR
Waiting Final Action 

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: