Uban, Daisy .

HRN: 28-56-44  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/14/2026
AZITHROMYCIN 500MG TABLET (TAB)
02/14/2026
02/19/2026
PO
500mg
OD
CAP-HR
Checking Initial Appropriateness 
02/14/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
02/14/2026
02/21/2026
IV
2.25gm
Q6h
CAP-HR
Checking Initial Appropriateness 
02/25/2026
MUPIROCIN 2%, 15G (TUBE)
02/25/2026
03/04/2026
TOPICAL
2%
BID
Infected Wound
Remove - Pending Acceptance
02/26/2026
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
02/26/2026
03/05/2026
TOPICAL
Small Amount
TID
Infected Wound
Remove - Pending Acceptance
03/19/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
03/19/2026
03/26/2026
IV INFUSION
400MG
Q24HRS
HAP
Checking Initial Appropriateness 
03/19/2026
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
03/19/2026
03/26/2026
IV
750mg
Q8hrs
HAP
Remove - Pending Acceptance
03/20/2026
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
03/20/2026
03/27/2026
TOPICAL
Wound
TID
Infected Wound
Remove - Pending Acceptance
03/22/2026
MUPIROCIN 2%, 15G (TUBE)
03/22/2026
03/29/2026
CUTANEOUS
2%
BID
Eczema
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: