Casipong, Bg Allain T.

HRN: 23 11 35  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/24/2023
FLUCONAZOLE 50MG (CAP)
05/24/2023
05/24/2023
PO
200mg
OD
Pulmonary Candidiasis
Checking Final Appropriateness 
05/24/2023
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
05/24/2023
05/27/2023
IV
500mg
OD
Cap
Checking Final Appropriateness 
05/24/2023
MUPIROCIN 2%, 15G (TUBE)
05/24/2023
05/30/2023
TOPICAL
Apply Thin Coat
BID
Decubitus Ulcer
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: