Labad, Jesseca D.

HRN: 13-18-82  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/25/2025
AMPICILLIN 1GM (VIAL)
08/25/2025
08/26/2025
IV
2 Grams
Q6
PPROM
Checking Initial Appropriateness 
08/26/2025
AMPICILLIN 1GM (VIAL)
08/26/2025
08/27/2025
IV
1gm
Q6hr X 2 Doses
Sp PLTCS
Checking Initial Appropriateness 
08/26/2025
CO-AMOXICLAV 625MG (TAB)
08/26/2025
09/01/2025
ORAL
500mg
BID
Sp PLTCS
Checking Initial Appropriateness 
08/28/2025
MUPIROCIN 2%, 15G (TUBE)
08/28/2025
08/28/2025
TOPICAL
1ml
OD
SP LTCS
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: