Dumpa, Ancilma D.

HRN: 24-10-35  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/02/2026
AMOXICILLIN 500MG CAPSULE (CAP)
06/02/2026
06/08/2026
PO
1g
BID
H PYLORI INFECTION
Checking Initial Appropriateness 
06/02/2026
CLARITHROMYCIN 500MG (CAP)
06/02/2026
06/08/2026
PO
500mg
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: