Gacang, Jacaius O.

HRN: 25-84-64  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/04/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
02/04/2026
02/11/2026
IV
340mg
Q6
Pcap C
Checking Initial Appropriateness 
02/06/2026
MUPIROCIN 2%, 15G (TUBE)
02/06/2026
02/13/2026
TOPICAL
2%
BID
Phlebitis
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: