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
10/07/2025
CEFTRIAXONE 1G (VIAL)
10/07/2025
10/14/2025
IV
1g
Q12
DM Foot
Waiting Final Action 
10/07/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
10/07/2025
10/14/2025
IV
600mg
Q8h
DM Foot
Waiting Final Action 
10/10/2025
AZITHROMYCIN 500MG TABLET (TAB)
10/10/2025
10/14/2025
PO
500mg Tab
OD
CAP-MR
Checking Final Appropriateness 
10/18/2025
CEFTRIAXONE 1G (VIAL)
10/18/2025
10/25/2025
IV
1g
Every 12 Hours
DM Foot
Waiting Final Action 
10/18/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
10/18/2025
10/25/2025
IV
600mg
Every 8 Hours
DM Foot
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: