Sularte, Larry Kim, Jr. .

HRN: 28-32-30  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/23/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/23/2025
12/29/2025
IV
380mg
Q6
PCAP
Checking Final Appropriateness 
12/24/2025
CO-AMOXICLAV 457MG/5ML, 70ML SUSPENSION (BOT)
12/24/2025
12/29/2025
PO
4ml
TID
PCAP
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: