Maurin, Wilfredo G.

HRN: 13-81-66  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/25/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
07/25/2025
07/31/2025
IV
600 Mg
Q 6 Hrs
Nonhealing Wound
Remove - Pending Acceptance
07/25/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
07/25/2025
07/31/2025
IV
1.5 Grams
Q 8 Hours
Nonhealing Wound
Remove - Pending Acceptance
07/30/2025
AMOXICILLIN 500MG CAPSULE (CAP)
07/30/2025
08/12/2025
ORAL
1g
Twice A Day
H. Pylori Infection
Remove - Pending Acceptance
07/30/2025
CLARITHROMYCIN 500MG (CAP)
07/30/2025
08/12/2025
ORAL
500mg
Twice A Day
H. Pylori Infection
Remove - Pending Acceptance
07/31/2025
CEFTRIAXONE 1G (VIAL)
07/31/2025
08/08/2025
IV
2g
OD
Cap
Remove - Pending Acceptance
09/02/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
09/02/2025
09/09/2025
IVTT
300
Q6
Empiric
Checking Initial Appropriateness 
09/02/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
09/02/2025
09/09/2025
IVT
4.5
Q8
Empiric
Checking Initial Appropriateness 
09/06/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
09/06/2025
09/13/2025
IV
2.25
Q6
Sepsis Secondary To Sacral Ulcer Grade 3
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: