Musa, Mary Jane .

HRN: 27-86-73  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/22/2025
AMPICILLIN 1GM (VIAL)
11/22/2025
11/24/2025
IV
2 G
Every 6 Hours
Leaking BOW
Checking Initial Appropriateness 
11/23/2025
CO-AMOXICLAV 625MG (TAB)
11/23/2025
11/30/2025
ORAL
625mg
BID
S/P NSD With Repair
Checking Initial Appropriateness 

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: