Segovia, Wenelyn L.

HRN: 26-56-41  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/26/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/26/2026
02/26/2026
IV
1gm
PTOR
For STAT CS With BTL
Remove - Pending Acceptance
02/28/2026
MUPIROCIN 2%, 15G (TUBE)
02/28/2026
03/06/2026
TOPICAL
2%
BID X 7days
Sp PLTCS
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: