Agan, Francis James B.

HRN: 27-35-17  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/19/2025
CEFTRIAXONE 1G (VIAL)
06/19/2025
06/26/2025
IVTT
2g
Of
T/C Acute Pancreatitis
Checking Initial Appropriateness 
06/20/2025
AMOXICILLIN 500MG CAPSULE (CAP)
06/20/2025
06/27/2025
PO
1g
Q12
H. Pyrori
Checking Initial Appropriateness 
06/20/2025
CLARITHROMYCIN 500MG (CAP)
06/20/2025
06/27/2025
PO
500
Q12
H. Pylori
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: