Mongaya, Rio D.

HRN: 21-16-82  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/17/2024
CEFTRIAXONE 1G (VIAL)
01/17/2024
01/24/2024
IV
1.5g
OD
Nephrotic Syndrome
Waiting Final Action 
01/17/2024
CLINDAMYCIN 150MG/ML, 4ML (AMP)
01/17/2024
01/24/2024
IV
100mg
Q6hrs
T/C Fournier Gangrene
Waiting Final Action 
01/17/2024
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
01/17/2024
01/24/2024
IV
200mg
Q8H
T/c Fournier’s Gangrene; Infected Wound
Waiting Final Action 
01/17/2024
MUPIROCIN 2%, 15G (TUBE)
01/17/2024
01/24/2024
TOPICAL
Apply Thinly
BID
T/c Fournier’s Gangrene; Infected Wound
Waiting Final Action 
01/19/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/19/2024
01/26/2024
IV
875mg
Q8
Obstructive Uropathy; TC Fournier's Gangrene
Waiting Final Action 
01/20/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/20/2024
01/27/2024
IV
650mg
Q6
Tc Fournier's Gangrene
Waiting Final Action 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: