Balansag, Rodelia B.

HRN: 08-69-08  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/15/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
09/15/2025
09/22/2025
IV
4.5gm
Q6h
Diabetic Food-none Healing Wound
Checking Initial Appropriateness 
09/16/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
09/16/2025
09/22/2025
IV
600mg
Q8
Infected Wound
Checking Initial Appropriateness 
09/16/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
09/16/2025
09/22/2025
IV
2.25gm
Q8
Infected Wound
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: