Nacua, Francisco .

HRN: 12-93-50  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/14/2025
AZITHROMYCIN 500MG TABLET (TAB)
10/14/2025
10/18/2025
PO
500mg
Od
CAP MR
Waiting Final Action 
10/14/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
10/14/2025
10/21/2025
IV
4.5g
Q8
VENOUS STASIS DERMATITIS
Waiting Final Action 
10/14/2025
MUPIROCIN 2%, 15G (TUBE)
10/14/2025
10/14/2025
1G
TOPICAL
BID
VENOUS STASIS DERMATITIS
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: