Saman, Ezekiel .

HRN: 29-21-65  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/26/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/26/2026
07/02/2026
IV
960mg
Q6
Dental 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: