Salipa, Shiela -.

HRN: 27-20-99  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/31/2025
ALBENDAZOLE 400MG (TAB)
05/31/2025
05/31/2025
ORAL
400mg
Single Dose
Ascaris Infection
Waiting Final Action 
06/01/2025
CIPROFLOXACIN 500MG (TAB)
06/01/2025
06/07/2025
PO
1 Tab
BID
Acute Infectious Diarrhea
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: