Ariza, Romeo Sr B.

HRN: 27-74-54  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/18/2025
AMOXICILLIN 500MG CAPSULE (CAP)
12/18/2025
01/01/2026
PO
2 Caps
BID
H PYLORI INFECTION
Checking Final Appropriateness 
12/18/2025
METRONIDAZOLE 500MG (TAB)
12/18/2025
01/01/2026
PO
500mg
TID
H Pylori Infection
Checking Final Appropriateness 
12/23/2025
LEVOFLOXACIN 500MG (TAB)
12/23/2025
01/03/2026
PO
250mg/tab
Every Other Day
Helicobacter Pylori Infection
Checking Initial Appropriateness 
12/24/2025
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
12/24/2025
12/31/2025
IV
250
Q Every Other Day
CAP MR
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: