Gonzales, Nelson E.

HRN: 23-29-15  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/04/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
07/04/2023
07/10/2023
IVTT
1.5 G
Q8
Burns
Waiting Final Action 
07/04/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
07/04/2023
07/10/2023
IVT
1.5g
Q6
Burns
Waiting Final Action 
07/04/2023
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
07/04/2023
07/10/2023
TOPICAL
1%
BID
Burn
Waiting Final Action 
07/07/2023
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
07/07/2023
08/04/2023
TOPICAL
1%
BID
Burn
Waiting Final Action 
07/13/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
07/13/2023
07/20/2023
IV
4.5g
Q6hrs
Infected Burn Wound
Waiting Final Action 
07/13/2023
AZITHROMYCIN 500MG TABLET (TAB)
07/13/2023
07/20/2023
PO
500mg
Q24hrs
CAP-MR
Waiting Final Action 
07/15/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
07/15/2023
07/22/2023
IVT
600mg
Q8hours
2nd-4th Degree Burn Sec To Electrical Burn
Waiting Final Action 
07/19/2023
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
07/19/2023
07/26/2023
TOPICAL
1%
BID
Burns
Checking Final Appropriateness 
07/21/2023
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
07/21/2023
07/27/2023
TOPICAL
1squirt
BID
Burn Wounds
Waiting Final Action 
08/02/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
08/02/2023
08/08/2023
IV INFUSION
450 Mg
Q12
Sepsis/pneumonia
Waiting Final Action 
08/02/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
08/02/2023
08/08/2023
IV
1.5
Q6
Burn Wounds
Waiting Final Action 
08/08/2023
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
08/08/2023
08/21/2023
TOPICAL
Apply On Affected Areas Bid
Bid
Burns
Checking Final Appropriateness 
08/08/2023
MUPIROCIN 2%, 15G (TUBE)
08/08/2023
08/21/2023
TOPICAL
Apply On Affected Areas
Bid
Pressure Ulcers
Checking Final Appropriateness 
08/10/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
08/10/2023
08/13/2023
IV
1.5 G
Q6
Pneumonia /sepsis
Checking Final Appropriateness 
08/10/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
08/10/2023
08/13/2023
IV
450
12
Sepsis/pneumonia
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: