AMS Audit

Lingating, Esterlita .

HRN: 06-81-30 Sex: Female

Patient Encounter

AMS Audit List

Audit Date

Antimicrobial

Start Date

End Date

Route

Dose

Frequency

Indication Documented

AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)

Waiting Final Action

CLINDAMYCIN 150MG/ML, 4ML (AMP)

Waiting Final Action

MUPIROCIN 2%, 15G (TUBE)

Blisters, Breast Malignancy R, S/p MRM R

Waiting Final Action

SODIUM FUSIDATE 20MG/G, 15G OINTMENT

Infected Wound, Breast

Waiting Final Action

SODIUM FUSIDATE 20MG/G, 15G OINTMENT

Infected Post-op MRM Site

Waiting Final Action

MUPIROCIN 2%, 15G (TUBE)

Sufficient Amount

Waiting Final Action

SODIUM FUSIDATE 20MG/G, 15G OINTMENT

Waiting Final Action

PIPERACILLIN + TAZOBACTAM 4.5G (VLS)

Infected Wound, Breast

Waiting Final Action

LEVOFLOXACIN 5MG/ML, 100ML (VIAL)

Infected Wound, Breast

Waiting Final Action

MUPIROCIN 2%, 15G (TUBE)

S/p Pig Tail Insertion

Waiting Final Action

SODIUM FUSIDATE 20MG/G, 15G OINTMENT

S/P Pig Tail Insertion; Breast CA

Waiting Final Action

AMS Audit Form

Start Date: End Date:

Indication:

Prophylaxis Empiric Culture-directed Empirical Escalation Empirical de-escalation Empiric then culture-directed

Type of Infection:

Urinary tract Pneumonia URTI Bloodstream Bone & joint Skin & soft tissue Intra-abdominal Eye, ear, nose, throat, & mouth Cardiovascular Reproductive tract Central nervous system

Febrile neutropenia Disseminated systemic infection Unspecified sepsis Multiple infections (tick all sites) Prophylaxis

Compliance to guidelines:

Compliant to guidelines Non-compliant to guidelines Guideline not available

Initial appropriateness:

Yes No

If inappropriate:

No infection Wrong choice Wrong route Wrong dose

Final appropriateness:

Yes No

Overall appropriateness:

Yes No