Pandac, Elyn Jean C.

HRN: 21-28-41  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/03/2023
AMOXICILLIN 250MG/5ML, 60ML SUSPENSION (BOT)
12/03/2023
12/10/2023
PO
2.5ml
Q8hours
H Pylori Infection
Waiting Final Action 
12/03/2023
METRONIDAZOLE 125MG/5ML, 60ML (BOT)
12/03/2023
12/10/2023
PO
4.5ml
Q8hours
H. Pylori Infection
Waiting Final Action 
12/04/2023
NYSTATIN 100,000IU/ML, 30ML SUSPENSION (BOT)
12/04/2023
12/10/2023
PO
100,000IU
TID
Mouth Sore
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: