Musa, Aries S.

HRN: 20-78-77  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/01/2022
AMPICILLIN 250MG (VIAL)
06/01/2022
06/07/2022
IVT
122.5
Q6 For 7 Days
Pneumonia
Waiting Final Action 
06/04/2022
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
06/04/2022
06/10/2022
PO
1.5ml
Q12
PCAP C
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: