Marzon, Alex M.

HRN: 27-20-24  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/14/2025
METRONIDAZOLE 500MG (TAB)
08/14/2025
08/21/2025
ORAL
500mg
Tid
Acalculous Cholecystitis
Remove - Pending Acceptance
08/16/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
08/16/2025
08/23/2025
IV
1.5
Q8
CAP
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: