Alejandrino, Crispulo F.

HRN: 20-80-29  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/06/2026
CEFTRIAXONE 1G (VIAL)
05/06/2026
05/12/2026
IV
2g
OD
Non-healing Wound
Remove - Pending Acceptance
05/06/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
05/06/2026
05/12/2026
IV
600mg
Q6
Nonhealing Wound
Remove - Pending Acceptance
05/06/2026
MUPIROCIN 2%, 15G (TUBE)
05/06/2026
05/12/2026
TOPICAL
15g
BID
Nonhealing Wound
Remove - Pending Acceptance
05/06/2026
AZITHROMYCIN 500MG TABLET (TAB)
05/06/2026
05/10/2026
ORAL
500mg
OD
CAP-MR
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: