Tagapan, Letty B.

HRN: 24 43 84  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/16/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/16/2024
01/22/2024
IV INFUSION
1.5gm
Q6
Non Healing Wound
Checking Final Appropriateness 
01/16/2024
CLINDAMYCIN 150MG/ML, 4ML (AMP)
01/16/2024
01/22/2024
IV
600mg
Q8
Non Healing Wound
Checking Final Appropriateness 
01/26/2024
LEVOFLOXACIN 500MG (TAB)
01/26/2024
02/02/2024
PO
1 Tab
OD
Complicated UTI
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: