Capadiso, Rhian .

HRN: 28-13-80  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/21/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
11/21/2025
11/28/2025
IV
325mg
Q6h
PCAP
Checking Initial Appropriateness 
11/25/2025
CO-AMOXICLAV 457MG/5ML, 70ML SUSPENSION (BOT)
11/25/2025
12/02/2025
PO
3ml
2x/day
UTI
Checking Final Appropriateness 
11/25/2025
CO-AMOXICLAV 457MG/5ML, 70ML SUSPENSION (BOT)
11/25/2025
12/02/2025
PO
3mL
2x/day
AGE With Mod DHN
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: