Sarmiento, Rosita R.

HRN: 11-38-12  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/17/2026
CEFTRIAXONE 1G (VIAL)
05/17/2026
05/23/2026
IV
2g
Od
UTI
Checking Initial Appropriateness 
05/20/2026
CIPROFLOXACIN 500MG (TAB)
05/20/2026
05/27/2026
PO
1 Tablet
BID
H. Pylori Infection
Checking Final Appropriateness 
05/20/2026
AMOXICILLIN 500MG CAPSULE (CAP)
05/20/2026
05/27/2026
PO
2 Tabs
BID
H. Pylori Infection
Checking Final Appropriateness 
05/20/2026
CLARITHROMYCIN 500MG (CAP)
05/20/2026
05/27/2026
PO
1 Tablet
BID
H. Pylori Infection
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: