Gonzales, Maura P.

HRN: 29-23-44  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/01/2026
CEFTRIAXONE 1G (VIAL)
07/01/2026
07/07/2026
IV
2g
Q24
Uti
Remove - Pending Acceptance
07/01/2026
AMOXICILLIN 500MG CAPSULE (CAP)
07/01/2026
07/14/2026
PO
500mg
BID
H. Pylori Infection
Remove - Pending Acceptance
07/01/2026
CLARITHROMYCIN 500MG (CAP)
07/01/2026
07/10/2026
PO
500mg
BID
H. Pylori Infection
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: