Pielago, Maricel E.

HRN: 15-55-69  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/26/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
07/26/2023
08/03/2023
IV
500mg
Q8
AGE
Waiting Final Action 
07/28/2023
CLARITHROMYCIN 500MG (CAP)
07/28/2023
08/11/2023
PO
500mg
BID
H Pylori
Waiting Final Action 
07/28/2023
AMOXICILLIN 500MG CAPSULE (CAP)
07/28/2023
08/11/2023
PO
500mg 2 Caps
BID
H Pylori
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: