Mayormita, Ronald F.

HRN: 28-69-11  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/12/2026
METRONIDAZOLE 500MG (TAB)
03/12/2026
03/19/2026
PO
500mg
TID
Infectious Diarrhea
Checking Initial Appropriateness 
03/14/2026
CO-AMOXICLAV 625MG (TAB)
03/14/2026
03/20/2026
IV
625mg
TID
Presumptive TB; AGE With Moderate Dehydration
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: