Amis, Zameer .

HRN: 21-34-61  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/04/2022
AMPICILLIN 500MG (VIAL)
07/04/2022
07/10/2022
IVT
120mg
Q6
Pcap C
Waiting Final Action 
09/27/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
09/27/2022
10/04/2022
IV
315 Mg
Q6
PCAP-C
Waiting Final Action 
10/01/2022
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
10/01/2022
10/08/2022
PO
2ml
Q12
PCAP C
Waiting Final Action 
10/01/2022
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
10/01/2022
10/05/2022
PO
1.5ml On Day 1, Then 0.8ml On Day2-Day5
OD
PcAP C
Waiting Final Action 
10/02/2022
CO-AMOXICLAV 457MG/5ML, 70ML SUSPENSION (BOT)
10/02/2022
10/09/2022
PO
1ml
BID
Pcap C
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: