Verallo, Rosendo M.

HRN: 23-65-76  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/07/2023
CEFTRIAXONE 1G (VIAL)
09/07/2023
09/13/2023
IV
2g
OD
CAP-MR
Waiting Final Action 
09/12/2023
AMOXICILLIN 500MG CAPSULE (CAP)
09/12/2023
09/26/2023
PO
500mgtab
2 Caps Bid
H. Pylori Infection
Waiting Final Action 
09/12/2023
CLARITHROMYCIN 500MG (CAP)
09/12/2023
09/26/2023
PO
500mgtab
BID
H. Pylori Infection
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: