Dela Cruz, Isabelo R.

HRN: 11 13 65  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/27/2024
CLINDAMYCIN 150MG/ML, 4ML (AMP)
08/27/2024
09/02/2024
IV
600mg
Q6
Infected Wound
Waiting Final Action 
08/27/2024
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
08/27/2024
09/02/2024
IV
1.5gm
Q6
Infected Wound
Waiting Final Action 
08/27/2024
CEFTRIAXONE 1G (VIAL)
08/27/2024
09/02/2024
IV
2gm
OD
Soft Tissue Infection
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: