Salugan, Nina H.

HRN: 26-48-68  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/19/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/19/2026
06/25/2026
IV
1.5g
Q6h
Bed Sore
Checking Initial Appropriateness 
06/19/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
06/19/2026
06/25/2026
IV
600mg
Q8h
Bed Sore
Checking Initial Appropriateness 
06/20/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
06/20/2026
06/20/2026
IV
4.5
Loading Dose
Sacral Ulcer
Checking Initial Appropriateness 
06/20/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
06/20/2026
06/26/2026
IV
2.25
8q
Sacral Ulcer
Checking Initial Appropriateness 
06/23/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
06/23/2026
06/30/2026
IVT
4.5g
Q8
Decubitus Ulcer
Checking Initial Appropriateness 
06/23/2026
MUPIROCIN 2%, 15G (TUBE)
06/23/2026
06/30/2026
TOPICAL
15%
BID
Decubitus Ulcer
Checking Initial Appropriateness 
07/14/2026
CEFIXIME 200MG (CAP)
07/14/2026
07/21/2026
PO
200mg Tab
Bid
Skin And Soft Tissue Infection
Checking Final Appropriateness 
07/17/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/17/2026
07/23/2026
IV INFUSION X 1 HR
800mg
OD
Decubitus Ulcer
Checking Final Appropriateness 
07/20/2026
CIPROFLOXACIN 500MG (TAB)
07/22/2026
07/28/2026
ORAL
500MG
BID
DECUBITUS 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: