Jala, Alibon .

HRN: 24-01-09  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/29/2023
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
10/29/2023
11/12/2023
IV
500mg
Q8
H. Pylori
Waiting Final Action 
10/29/2023
CLARITHROMYCIN 500MG (CAP)
10/29/2023
11/12/2023
PO
1 Tab
BID
H. Pylori
Waiting Final Action 
10/30/2023
AMOXICILLIN 500MG CAPSULE (CAP)
10/30/2023
11/12/2023
ORAL
1 Gram
BID
H. Pylori
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: