Lapinig, Dionesio S.

HRN: 10-78-45  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/22/2026
CEFTAZIDIME 1GM (VIAL)
06/22/2026
06/29/2026
IV
2g
Q8
CAPMR
Checking Initial Appropriateness 
06/22/2026
AZITHROMYCIN 500MG IV
06/22/2026
06/26/2026
IV
500mg
OD
CAPMR
Checking Initial Appropriateness 
06/29/2026
MUPIROCIN 2%, 15G (TUBE)
06/29/2026
07/06/2026
TOPICAL
Apply On Affected Area
BID
Decubitus Ulcer
Checking Initial Appropriateness 
06/30/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
06/30/2026
07/07/2026
IVTT
4.5G
Q8H
CAP-HR
Checking Initial Appropriateness 
06/30/2026
LEVOFLOXACIN 5MG/ML, 100ML (VIAL)
06/30/2026
07/07/2026
IVTT
750MG
OD
CAP-HR
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: