Rosales, Evelyn I.

HRN: 24-77-13  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/27/2024
CEFTRIAXONE 1G (VIAL)
03/27/2024
04/03/2024
IVTT
2G
OD
UTI
Checking Final Appropriateness 
04/01/2024
MUPIROCIN 2%, 15G (TUBE)
04/01/2024
04/07/2024
TOPICAL
Ample Amount
During HD
IJ Cath Insertion Prophylaxis
Checking Final Appropriateness 
04/01/2024
SODIUM FUSIDATE 20MG/G, 15G OINTMENT
04/01/2024
04/07/2024
TOPICAL
20mg/g
During HD
IJ Cath Insertion Prophylaxis
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: