Sapaih, Norsa .

HRN: 06-28-58  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/08/2026
AMPICILLIN 1GM (VIAL)
02/08/2026
02/14/2026
IV
2 Grams
Q6
PROM
Remove - Pending Acceptance
02/09/2026
CO-AMOXICLAV 625MG (TAB)
02/09/2026
02/15/2026
PO
625
BID
PROM 10 Hrs
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: