Balo-at, Shaed A.

HRN: 25-35-38  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/25/2025
CEFUROXIME 1.5GM (VIAL)
10/25/2025
10/31/2025
IV
800mg
Q8
URTI
Checking Final Appropriateness 
10/28/2025
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
10/28/2025
11/10/2025
PO
5ml
BID
H Pylori Infection
Checking Final Appropriateness 
10/28/2025
METRONIDAZOLE 125MG/5ML, 60ML (BOT)
10/28/2025
11/10/2025
PO
10ml
TID
H Pylori Infection
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: