Piedad, Michelle .

HRN: 26-87-46  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/27/2025
AMPICILLIN 1GM (VIAL)
03/27/2025
04/01/2025
IV
2g
Q6hr
PROM
Waiting Final Action 
03/27/2025
CEFAZOLIN 1GM (VIAL)
03/27/2025
03/27/2025
IV
2g
PTOR
For STAT CS
Waiting Final Action 
03/28/2025
CEFUROXIME 500MG (TAB)
04/03/2025
03/28/2025
PO
500mg
BID
S/P PLTCS
Waiting Final Action 
03/28/2025
MUPIROCIN 2%, 15G (TUBE)
03/28/2025
04/03/2025
TOPICAL
15g
BID
S/P PLTCS
Waiting Final Action 
03/28/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
03/27/2025
03/28/2025
IV
240mg
OD
S/P PLTCS
Waiting Final Action 
03/28/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
03/27/2025
03/28/2025
IV
900mg
Q8
S/P PLTCS
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: