Rocamora, Edwin Z.

HRN: 29-08-77  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/03/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/03/2026
06/09/2026
IV
1.5g
Q6h
Sacral Ulcer
Checking Final Appropriateness 
06/03/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
06/03/2026
06/09/2026
IV
600mg
Q6h
Sacral Ulcer
Checking Final Appropriateness 
06/03/2026
CEFTAZIDIME 1GM (VIAL)
06/03/2026
06/09/2026
IV
2gm
Q8h
Sacral Ulcer
Checking Final 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: