Indal, Hussin A.

HRN: 23-95-85  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/28/2023
AMOXICILLIN 500MG CAPSULE (CAP)
10/28/2023
11/11/2023
ORAL
500mg
Two Tabs Every 12hours
Empiric
Checking Final Appropriateness 
10/28/2023
CLARITHROMYCIN 500MG (CAP)
10/28/2023
11/11/2023
ORAL
500mg
1 Tab Every 12hours
Empiric
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: