Intol, Iralee B.

HRN: 24-02-52  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/05/2023
AMOXICILLIN 500MG CAPSULE (CAP)
11/05/2023
11/19/2023
PO
500 Mg
BID
Peptic Ulcer Disease
Rejected 
11/05/2023
CLARITHROMYCIN 500MG (CAP)
11/05/2023
11/19/2023
PO
500 Mg
BID
Peptic Ulcer Disease
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: