Ingcoy, Evelyn T.

HRN: 21-53-07  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/09/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
07/09/2022
07/16/2022
IV
1.5g
Q6
Infected Breast Mass, Left
Waiting Final Action 
07/09/2022
CLINDAMYCIN 150MG/ML, 4ML (AMP)
07/09/2022
07/16/2022
IV
600mg
Q6
Infected Breast Mass, Left
Waiting Final Action 
07/09/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
07/09/2022
07/16/2022
IV
1.5gm
Q6
Nonhealing Wound
Waiting Final Action 
07/12/2022
MUPIROCIN 2%, 15G (TUBE)
07/12/2022
07/19/2022
TOPICAL
Adequate Amount Apply To Affected Area
Q12
Infected Wound
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: