Sumayang, Nolasco L.

HRN: 24-37-97  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/10/2024
CLINDAMYCIN 150MG/ML, 4ML (AMP)
01/10/2024
02/09/2024
IV
600mg
Q6
Cellulitis Left Leg
Checking Final Appropriateness 
01/10/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/10/2024
01/16/2024
IV
1.5gm
Q6
Cellulitis Left Leg
Checking Final Appropriateness 
01/14/2024
CEFTRIAXONE 1G (VIAL)
01/14/2024
01/21/2024
IV
2g
Q24
Cellulitis Left Leg; R/O PAOD
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: