Lipae, Samriya .

HRN: 22-45-29  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/04/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/04/2023
01/10/2023
IVT
300mg
Q6
PCAP C
Waiting Final Action 
01/05/2023
CLARITHROMYCIN 125MG/5ML, 60ML SUSPENSION (BOT)
01/05/2023
01/12/2023
PO
2ml
BID
PCAP-C
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: