Omar, Atheelah B.

HRN: 27-27-24  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/28/2025
AMPICILLIN 1GM (VIAL)
10/28/2025
11/04/2025
IV
280mg
Q6
PCAP-C
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: