Balsamo, Princess Jhanna .

HRN: 29-08-43  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/01/2026
CEFUROXIME 750MG (VIAL)
06/01/2026
06/08/2026
IV
400mg
Q8hours
UTI
Checking Initial Appropriateness 
06/02/2026
MUPIROCIN 2%, 15G (TUBE)
06/02/2026
06/09/2026
TOPICAL
As Needed
BID
Acute Bacterial 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: