Gapor, John Eros Dwayne .

HRN: 25-80-10  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/28/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
04/28/2026
05/05/2026
IV
600mg
Q6
Superimposed Bacterial Infection Prob. Sec. To Varicella Infection
Remove - Pending Acceptance
04/28/2026
MUPIROCIN 2%, 15G (TUBE)
04/28/2026
05/05/2026
TOPICAL
15g
TID
Superimposed Bacterial Infection Prob. Sec. To Varicella Infection
Remove - Pending Acceptance
04/28/2026
ACICLOVIR 400MG (TAB)
04/28/2026
05/05/2026
PO
200mg/pptab, 1pptab
QID
Superimposed Bacterial Infection Prob. Sec. To Varicella Infection
Remove - Pending Acceptance

AMS Audit Form


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Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: