Arnaiz, Antonio Jr. B.

HRN: 21-33-87  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/05/2025
CLOXACILLIN 500MG (CAP)
05/05/2025
05/19/2025
PO
500mg
BID
H. Pylori Infection
Waiting Final Action 
05/05/2025
AMOXICILLIN 500MG CAPSULE (CAP)
05/05/2025
05/19/2025
PO
500mg 2 Tabs
BID
H. Pylori Infection
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: