Asis, Nelma S.

HRN: 23-72-67  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/23/2023
CLARITHROMYCIN 500MG (CAP)
09/23/2023
10/07/2023
ORAL
500mg/cap
BID
H. Pylori Infection
Checking Final Appropriateness 
09/23/2023
MEBENDAZOLE 500MG (TAB)
09/23/2023
10/07/2023
ORAL
500mg/tab
BID
H. Pylori Infection
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: