Balano, Renato N.

HRN: 28-69-75  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/18/2026
AMOXICILLIN 500MG CAPSULE (CAP)
03/18/2026
04/01/2026
1G
1g
BID
H. Pylori
Remove - Pending Acceptance
03/18/2026
CLARITHROMYCIN 500MG (CAP)
03/18/2026
04/01/2026
PO
500
BID
H. Pylori
Remove - Pending Acceptance
03/18/2026
METRONIDAZOLE 500MG (TAB)
03/18/2026
04/01/2026
PO
500
TID
H. Pylori
Remove - Pending Acceptance

AMS Audit Form


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Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: