Catalya, Teresita E.

HRN: 28-71-99  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/24/2026
CLARITHROMYCIN 500MG (CAP)
03/24/2026
03/31/2026
PO
500mg
Q12
Peptic Ulcer Disease
Checking Initial Appropriateness 
03/24/2026
AMOXICILLIN 500MG CAPSULE (CAP)
03/24/2026
03/31/2026
PO
1g
Q12
Peptic Ulcer Disease
Checking Initial Appropriateness 
03/24/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/24/2026
03/31/2026
IV
4.5g
Q8
Complicated UTI
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: