Padilla, Carmelita L.

HRN: 28-98-54  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/12/2026
CEFTRIAXONE 1G (VIAL)
05/12/2026
05/18/2026
IV
2G
OD
CAP MR
Checking Initial Appropriateness 
05/12/2026
MUPIROCIN 2%, 15G (TUBE)
05/12/2026
05/18/2026
TOPICAL
.
OD
SKIN INFECTION
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: