Bagalanon, Elenita V.

HRN: 16-44-66  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/19/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
05/19/2026
05/25/2026
IV
2.25
Q6
Diabetic Foot
Checking Initial Appropriateness 
05/19/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
05/19/2026
05/25/2026
IV
600mg
Q6
Diabetic Foot
Checking Initial Appropriateness 
05/19/2026
MUPIROCIN 2%, 15G (TUBE)
05/19/2026
05/25/2026
TOPICAL
2%
Q12
Dia
Checking Initial Appropriateness 
05/19/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
05/19/2026
05/19/2026
IV
4.5g
Loading Dose
CAP MR
Rejected 
05/20/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
05/20/2026
05/27/2026
IV
500mg
Q8H
DM FOOT
Checking Final Appropriateness 
05/25/2026
CEFTRIAXONE 1G (VIAL)
05/25/2026
06/01/2026
IVTT
2g
OD
NONHEALING WOUND
Checking Initial Appropriateness 
05/25/2026
MUPIROCIN 2%, 15G (TUBE)
05/25/2026
06/01/2026
TOPICAL
Apply On Affected Are
BID
Nonhealing Wound
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: