Caril, Sitti D.

HRN: 01-08-95  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/31/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
03/31/2026
04/07/2026
IV
500mg
Q8H
Amoebiasis
Checking Initial Appropriateness 
04/02/2026
CIPROFLOXACIN 500MG (TAB)
04/02/2026
04/09/2026
ORAL
500mg
BID
UTI
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: