Tumbale, Damian E.

HRN: 28-43-76  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/06/2026
CEFTAZIDIME 1GM (VIAL)
03/06/2026
03/12/2026
IV
2gm
Q8
Cap Mr
Remove - Pending Acceptance
03/06/2026
AZITHROMYCIN 500MG TABLET (TAB)
03/06/2026
03/12/2026
IV
500mgtab
Q24
Cap Mr
Remove - Pending Acceptance
03/08/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/08/2026
03/15/2026
IV
4.5
Q8
Pneumonia
Checking Initial Appropriateness 
03/09/2026
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
03/09/2026
03/15/2026
IV
500mg
OD
PTB
Checking Initial Appropriateness 
03/12/2026
MUPIROCIN 2%, 15G (TUBE)
03/12/2026
03/18/2026
TOPICAL
2%
Every 8hrs
Pressure Ulcer
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: