AMS Audit

Wagas, Segundina .

HRN: 28-62-43 Sex: Female

Patient Encounter

AMS Audit List

Audit Date

Antimicrobial

Start Date

End Date

Route

Dose

Frequency

Indication Documented

CEFTRIAXONE 1G (VIAL)

Checking Initial Appropriateness

CLINDAMYCIN 150MG/ML, 4ML (AMP)

Decubitus Ulcer

Checking Initial Appropriateness

PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)

4.5mg Then 2.5mg

Checking Initial Appropriateness

SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)

Checking Initial Appropriateness

LEVOFLOXACIN 500MG (TAB)

Checking Initial Appropriateness

SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)

Checking Initial Appropriateness

SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)

Checking Initial Appropriateness

SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)

Checking Initial Appropriateness

SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)

Checking Initial Appropriateness

SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)

Apply Thon Coat

Decubitus Ulcer

Checking Initial Appropriateness

CEFIXIME 200MG (CAP)

Checking Initial Appropriateness

AMIKACIN 250MG/ML, 2ML (VIAL/AMP)

Skin And Soft Tissue Infection

Checking Initial Appropriateness

RIFAXIMIN 200MG (TAB)

Stercoral Ulcer

Checking Initial Appropriateness

SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)

Decubitus Ulcer

Checking Initial Appropriateness

SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)

Decubitus Ulcer

Checking Initial Appropriateness

AMS Audit Form

Start Date: End Date:

Indication:

Prophylaxis Empiric Culture-directed Empirical Escalation Empirical de-escalation Empiric then culture-directed

Type of Infection:

Urinary tract Pneumonia URTI Bloodstream Bone & joint Skin & soft tissue Intra-abdominal Eye, ear, nose, throat, & mouth Cardiovascular Reproductive tract Central nervous system

Febrile neutropenia Disseminated systemic infection Unspecified sepsis Multiple infections (tick all sites) Prophylaxis

Compliance to guidelines:

Compliant to guidelines Non-compliant to guidelines Guideline not available

Initial appropriateness:

Yes No

If inappropriate:

No infection Wrong choice Wrong route Wrong dose

Final appropriateness:

Yes No

Overall appropriateness:

Yes No