Capoy, Gresila B.

HRN: 26-59-20  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/26/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
01/26/2026
01/26/2026
IV
4.5g
LD
Decubitus Ulcer S4
Checking Initial Appropriateness 
01/26/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
01/26/2026
02/02/2026
IV
2.25g
Q6
Decubitus Ulcer S4
Checking Initial Appropriateness 
02/06/2026
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
02/06/2026
02/13/2026
TOPICAL
25g
BID
Decubitus Ulcer Stage 4
Checking Initial Appropriateness 
02/15/2026
MUPIROCIN 2%, 15G (TUBE)
02/15/2026
02/21/2026
TOPICAL
Generous Amount
Q12
Sacral Ulcer
Checking Initial Appropriateness 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: