Ordeniza, Sharon .

HRN: 22-89-24  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/22/2023
AMPICILLIN 1GM (VIAL)
05/22/2023
05/29/2023
IV
2g
Q6
G3P1 (1011) PU CIL, PROM X 2HR
Checking Final Appropriateness 
05/23/2023
CO-AMOXICLAV 625MG (TAB)
05/23/2023
05/30/2023
PO
625
BID
RMLE
Checking Final Appropriateness 

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: