Romero, Maximo C.

HRN: 14-38-58  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/05/2026
CEFTRIAXONE 1G (VIAL)
03/05/2026
03/11/2026
IV
2g
OD
Infected Wound
Checking Initial Appropriateness 
03/05/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
03/05/2026
03/11/2026
IV
600mg
Q8
Infected Wound
Checking Initial Appropriateness 
03/10/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/10/2026
03/17/2026
IV
4.5g
Q 8 Hours
Infected Wound
Checking Initial Appropriateness 
03/14/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
03/14/2026
03/21/2026
IV DRIP
400 Mg
OD
Infected Wound Right Foot
Checking Initial Appropriateness 
03/19/2026
CO-AMOXICLAV 625MG (TAB)
03/19/2026
03/26/2026
PO
625mg
Tid
Dm Foot
Checking Initial Appropriateness 
03/19/2026
CO-AMOXICLAV 625MG (TAB)
03/19/2026
03/26/2026
PO
625mg
Tid
Dm Foot
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: