Sodicta, Meriam .

HRN: 15-36-39  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/03/2026
AMPICILLIN 1GM (VIAL)
05/03/2026
05/10/2026
IV
2 Grams
Q6
Promx 3 Hrs
Remove - Pending Acceptance
05/03/2026
METRONIDAZOLE 500MG (TAB)
05/04/2026
05/11/2026
PO
500 Mg
TID
LTCS
Remove - Pending Acceptance
05/03/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
05/03/2026
05/04/2026
IV
400
Q8
SP LTCS
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: