Ebbah, Dolores .

HRN: 04-05-27  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/03/2023
CO-AMOXICLAV 625MG (TAB)
11/03/2023
11/06/2023
PO
625mg
Q8
URTI
Checking Final Appropriateness 
11/05/2023
AZITHROMYCIN 500MG TABLET (TAB)
11/05/2023
11/09/2023
PO
500mg
OD
URTI
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: