Umban, Venerando S.

HRN: 26-27-38  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/10/2025
CEFTRIAXONE 1G (VIAL)
11/10/2025
11/17/2025
IV
2 Grams
Od
Non Healing Wound
Waiting Final Action 
11/10/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
11/10/2025
11/17/2025
IV
600
Q8
Non Healing Wound
Waiting Final Action 
11/16/2025
CEFTRIAXONE 1G (VIAL)
11/16/2025
11/23/2025
IV
2g
OD
Nonhealing Wound, Left Leg
Waiting Final Action 
11/16/2025
CLINDAMYCIN 150MG/ML, 4ML (AMP)
11/16/2025
11/23/2025
IV
600
Q8
Nonhealing Wound, Left Leg
Waiting Final Action 
11/17/2025
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
11/17/2025
11/17/2025
IV
4.5g
LD
Nonhealing Wound
Waiting Final Action 
11/17/2025
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
11/17/2025
11/24/2025
IV
2.25g
Q8
Nonhealing Wound
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: