CaÑeda, Rhyle M.

HRN: 25-67-39  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/27/2025
AMPICILLIN 1GM (VIAL)
11/27/2025
12/04/2025
IV
390MG
Q6H
PCAPC
Checking Final Appropriateness 
11/30/2025
AMOXICILLIN 250MG/5ML, 60ML SUSPENSION (BOT)
11/30/2025
12/04/2025
PO
3ml
Q 12
PCAP-C
Checking Initial 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: