Alibasa, Hanina .

HRN: 28-12-90  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/20/2026
CO-AMOXICLAV 625MG (TAB)
03/20/2026
03/26/2026
ORAL
625mg
BID
UTI
Remove - Pending Acceptance
03/20/2026
CO-AMOXICLAV 625MG (TAB)
03/20/2026
03/26/2026
ORAL
625mg
BID
UTI
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: