Remolta, Ailyn A.

HRN: 28-51-17  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/01/2026
CEFTRIAXONE 1G (VIAL)
02/01/2026
02/08/2026
IVT
2g
OD
Infected Wound Left Breast
Waiting Final Action 
02/01/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
02/01/2026
02/08/2026
IVT
600mg
Q6
Infected Wound Left Breast
Waiting Final Action 
02/08/2026
OXACILLIN 500MG (VIAL)
02/08/2026
02/14/2026
IV
500mg
Q6
Infected Wound Left Breast
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: