Manuel, Yangki A.

HRN: 22-81-77  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/03/2023
CEFTRIAXONE 1G (VIAL)
04/03/2023
04/09/2023
IV
2gm
Q24
CAP MR
Waiting Final Action 
04/04/2023
AZITHROMYCIN 500MG TABLET (TAB)
04/04/2023
04/06/2023
ORAL
500mg
OD
CAP MR
Waiting Final Action 
04/05/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
04/05/2023
04/11/2023
IV
1.5g
Q8h
Cap Mr
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: