Luzarin, Jhon Carlo A.

HRN: 18-55-29  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/02/2025
CIPROFLOXACIN 500MG (TAB)
07/02/2025
07/05/2025
PO
500mg
BID
Infectious Diarrhea
Checking Initial Appropriateness 
07/02/2025
CLARITHROMYCIN 500MG (CAP)
07/02/2025
07/15/2025
PO
500
BID
H Pylori Infection
Waiting Final Action 
07/02/2025
AMOXICILLIN 500MG CAPSULE (CAP)
07/02/2025
07/15/2025
PO
500 Mg
BID
H Pylori Infection
Waiting Final Action 
07/03/2025
CEFTRIAXONE 1G (VIAL)
07/03/2025
07/10/2025
IV
2 Gram
OD
Intra Abdominal Infections
Waiting Final Action 
07/03/2025
METRONIDAZOLE 500MG (TAB)
07/03/2025
07/10/2025
PO
500 Mg
Q8h
Intra Abdominal Infections
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: