Caputolan, Liam O.

HRN: 25-15-77  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/30/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/30/2025
01/06/2026
IV
600mg
Q6hours
PCAP-C
Checking Initial Appropriateness 
01/01/2026
CEFUROXIME 750MG (VIAL)
01/01/2026
01/08/2026
IV
400 Mg
Q8hrs
Pcap C
Checking Final Appropriateness 
01/01/2026
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
01/01/2026
01/08/2026
PO
3.6 Ml
Bid
Pcap C
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: