Vallente, Archie D.

HRN: 27-90-36  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/05/2025
AMPICILLIN 250MG (VIAL)
10/05/2025
10/12/2025
IV DRIP
135mg
Q12h
PSNB(ER Delivery)
Waiting Final Action 
10/06/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/06/2025
10/13/2025
IV DRIP
40mg
Q24h
PSNB(ER Delivery)
Waiting Final Action 

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: