Sales, Marcelina D.

HRN: 16-75-28  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/19/2026
CEFTRIAXONE 1G (VIAL)
04/19/2026
04/26/2026
IV
2g
OD
UTI
Checking Initial Appropriateness 
04/26/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
04/26/2026
05/03/2026
IV
500mg
Q6H
Intraabdominal Infection
Checking Initial Appropriateness 
05/10/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/10/2026
05/10/2026
IV
4.5g
Loading Dose
Cap Hr
Checking Initial Appropriateness 
05/10/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/10/2026
05/17/2026
IV
2.25
Q8
Cap Hr
Checking Initial Appropriateness 
05/21/2026
MUPIROCIN 2%, 15G (TUBE)
05/21/2026
05/27/2026
TOPICAL
Apply Thin Layer
Now
IJC Exit Site Prophylaxis
Checking Initial Appropriateness 
06/01/2026
MUPIROCIN 2%, 15G (TUBE)
06/01/2026
06/08/2026
TOPICAL
Apply On Affected Area
BID
Sacral Ulcer
Checking Initial Appropriateness 
06/11/2026
MUPIROCIN 2%, 15G (TUBE)
06/11/2026
06/17/2026
TOPICAL
Apply Thinly On Affected Areas
BID
Sacral Decubitus 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: