Banselan, Ramil U.

HRN: 28-71-21  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/20/2026
SILVER SULFADIAZINE 1%, 25G CREAM (TUBE)
03/20/2026
03/27/2026
TOPICAL
-
OD
Sacral Ulcer Grade 2-3
Remove - Pending Acceptance
03/20/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
03/20/2026
03/26/2026
IV
1.5g.
Q6
Decubitus Ulcer Sacral Area
Remove - Pending Acceptance
03/20/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
03/20/2026
03/26/2026
IV
600mg
Q8
Decubitus Ulcer Sacral Area
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: