Jamud, Carima A.

HRN: 28-45-17  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/26/2026
CEFAZOLIN 1GM (VIAL)
01/26/2026
01/27/2026
IV
2 G
Loading Dose
For Oophorectomy
Checking Initial Appropriateness 
01/26/2026
CEFAZOLIN 1GM (VIAL)
01/26/2026
01/27/2026
IV
2 G
Loading Dose
For Oophorectomy
Checking Initial Appropriateness 
01/27/2026
CEFUROXIME 500MG (TAB)
01/27/2026
02/03/2026
PO
500mg
BID X 7 Days
S/P Pelvic Lap
Checking Initial Appropriateness 
01/27/2026
MUPIROCIN 2%, 15G (TUBE)
01/27/2026
02/03/2026
TOPICAL
15g
BID
S/P Pelvic Lap
Checking Initial Appropriateness 
01/27/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
01/27/2026
02/02/2026
IV
4.5gm
Q6hr
TC HAP
Checking Initial Appropriateness 
01/27/2026
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
01/27/2026
02/02/2026
IV
500mg
OD
TC HAP
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: