Gordova, Eric C.

HRN: 09-27-01  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/03/2026
CLARITHROMYCIN 500MG (CAP)
04/03/2026
04/12/2026
ORLA
500MG
BID
H.pylori
Checking Initial Appropriateness 
04/03/2026
AMOXICILLIN 500MG CAPSULE (CAP)
04/03/2026
04/12/2026
ORAL
1gram
BID
H.pylori
Checking Initial Appropriateness 
04/03/2026
CIPROFLOXACIN 500MG (TAB)
04/03/2026
04/10/2026
TAB
500mg
BID
AGE
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: