Pendi, Asmihan .

HRN: 18-80-07  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/12/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/12/2025
10/19/2025
IV
375mg
Q6
Uti
Checking Final 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: