Tomo, Tristhan C.

HRN: 28-58-52  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/16/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
02/16/2026
02/23/2026
IV
200mg
Q6
Cellulitis
Checking Initial Appropriateness 
02/16/2026
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
02/16/2026
02/23/2026
TOPICAL
On Affected Site
TID
Burn
Checking Initial Appropriateness 
02/19/2026
CEFTRIAXONE 1G (VIAL)
02/19/2026
02/26/2026
IV
2g
OD
Cellulitis
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: