Pano, Rey C.

HRN: 23-82-72  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/03/2023
AMOXICILLIN 500MG CAPSULE (CAP)
10/03/2023
10/14/2023
PO
1gms
BID
H Pylori Gastritis
Checking Final Appropriateness 
10/03/2023
CLARITHROMYCIN 500MG (CAP)
10/03/2023
10/14/2023
PO
500mg
BID
H Pylori Gastritis
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: