Calib-og, Merlyn G.

HRN: 24-05-06  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/27/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/27/2025
02/10/2025
IV
1.5
Q8
Infected Breast Mass
Waiting Final Action 
01/27/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
01/27/2025
02/10/2025
IV
600
Q8
Infected Breast Mass
Waiting Final Action 
02/04/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
02/04/2025
02/11/2025
IV
1.5g
TID
Infected Breast Mass
Waiting Final Action 
02/04/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
02/04/2025
02/11/2025
IV
600
Q8
Infected Breast Mass
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: