Suson, Adelle .

HRN: 23-89-00  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/05/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/05/2026
06/12/2026
IV
300mg
Q6hrs
UTI
Checking Final Appropriateness 
06/05/2026
METRONIDAZOLE 125MG/5ML, 60ML (BOT)
06/05/2026
06/15/2026
PO
5mL
Q8h
Intestinal Amoebiasis
Checking Initial Appropriateness 
06/05/2026
CO-AMOXICLAV 457MG/5ML, 70ML SUSPENSION (BOT)
06/05/2026
06/12/2026
PO
3mL
BID
Infectious Diarrhea
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: