Yusop, Mia T.

HRN: 15 52 20  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/27/2023
MUPIROCIN 2%, 15G (TUBE)
06/27/2023
07/03/2023
TOPICAL
Apply Thin Coat
BID
Soft Tissue Infetion
Waiting Final Action 
06/27/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/27/2023
07/03/2023
IV
1.5g
Q6
UTI; Infected Wound
Waiting Final Action 
06/27/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
06/27/2023
07/03/2023
IV
600mg
Q8
UTI; 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: