Perez, Conchita L.

HRN: 20-58-75  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/02/2022
CLINDAMYCIN 150MG/ML, 4ML (AMP)
09/02/2022
09/08/2022
IV
600mg
Q4h
DM Foot
09/02/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
09/02/2022
09/08/2022
IV
1.5gm
TID
DM Foot
09/02/2022
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
09/02/2022
09/08/2022
IV
500mg
TID
Tetanus Infection
Waiting Final Action 
09/02/2022
CIPROFLOXACIN 500MG (TAB)
09/03/2022
09/10/2022
NGT
500mg
Q12hrs
Deep Neck Infection
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: