Malang, Rafaellah A.

HRN: 26-57-70  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/23/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/23/2025
01/29/2025
IV
300mg
Q6h
PCAP C
Waiting Final Action 
01/28/2025
AMOXICILLIN 100MG/ML, 10ML DROPS (BOT)
01/28/2025
02/03/2025
PO
1mL
TID
Pneumonia
Waiting Final Action 
01/28/2025
AZITHROMYCIN 200MG/5ML, 15ML SUSPENSION (SUSP)
01/28/2025
02/03/2025
PO
1.5mL
OD
Pneumonia
Waiting Final Action 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: