Carlito, Ephraim D.

HRN: 16-82-81  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/31/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/31/2022
01/06/2023
IV
365mg
Q6hours
URTI
Waiting Final Action 
01/04/2023
CO-AMOXICLAV 457MG/5ML, 70ML SUSPENSION (BOT)
01/04/2023
01/11/2023
ORAL
3ml
Q12h
Urti
Waiting Final Action 
01/04/2023
CO-AMOXICLAV 457MG/5ML, 70ML SUSPENSION (BOT)
01/04/2023
01/11/2023
ORAL
3ml
Q12h
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: