Gaas, Marcial G.

HRN: 19-12-67  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/13/2023
CEFTRIAXONE 1G (VIAL)
05/13/2023
05/19/2023
IV
2gma
OD
Infected Tophi
Waiting Final Action 
05/13/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
05/13/2023
05/21/2023
IV
1.5gm
TID
Infected Wound
Waiting Final Action 
05/13/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
05/13/2023
05/21/2023
IV
300mg
QID
Infected Wound
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: