Carcallas, Juan M.

HRN: 28-96-80  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/09/2026
CLARITHROMYCIN 500MG (CAP)
05/09/2026
05/16/2026
PO
500mg Cap
Q12
H Pylori
Checking Initial Appropriateness 
05/09/2026
CLARITHROMYCIN 500MG (CAP)
05/09/2026
05/16/2026
PO
500mgtab
Q12
H Pylori Infection
Checking Initial Appropriateness 
05/09/2026
CEFTRIAXONE 1G (VIAL)
05/09/2026
05/16/2026
IV
2g
Od
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: