De Guia, Lark Khalen A.

HRN: 20-97-84  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/02/2022
AMPICILLIN 250MG (VIAL)
11/02/2022
11/09/2022
IV
190mg
Q6hours
URTI
Waiting Final Action 
11/05/2022
CO-AMOXICLAV 457MG/5ML, 70ML SUSPENSION (BOT)
11/05/2022
11/08/2022
PO
1.4ml
Q12hours
URTI
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: