Tampal, Ponciano T.

HRN: 01-89-81  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/29/2023
CIPROFLOXACIN 500MG (TAB)
09/29/2023
10/06/2023
PO
500mg
Every 12hours
Empiric
Checking Final Appropriateness 
09/29/2023
MUPIROCIN 2%, 15G (TUBE)
09/29/2023
10/06/2023
PO
Apply Thinly
Every 12hours
Empiric
Checking Final Appropriateness 
10/01/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/01/2023
10/08/2023
IV
1.5g
Q6hrs
Multiple Lacerated Wound
Waiting Final Action 
10/06/2023
MUPIROCIN 2%, 15G (TUBE)
10/06/2023
10/12/2023
TOPICAL
Apply Thinly
BID
Soft Tissue Injury
Waiting Final Action 
10/07/2023
MUPIROCIN 2%, 15G (TUBE)
10/07/2023
10/14/2023
TOPICAL
2%
BID
Avulsed Wound
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: