Enricosa, Edcy .

HRN: 21-41-42  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/30/2022
AMPICILLIN 500MG (VIAL)
05/30/2022
06/05/2022
IVT
340mg
Q6
Pneumonia
Waiting Final Action 
06/02/2022
AMOXICILLIN 100MG/ML, 10ML DROPS (BOT)
06/02/2022
06/09/2022
PO
1ml
Every 8h
PCAP C
Waiting Final Action 
06/02/2022
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
06/02/2022
06/09/2022
PO
2ml
Q12h
PCAP C
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: