Adolfo, Roshaine .

HRN: 20-55-49  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/13/2022
AMPICILLIN 250MG (VIAL)
08/13/2022
08/20/2022
IVT
170mg
Q6
T/C UTI
Waiting Final Action 
08/13/2022
MUPIROCIN 2%, 15G (TUBE)
08/13/2022
08/20/2022
TOPICAL
Pea-size
BID
Skin 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: