Guimalan, Miguela D.

HRN: 29-21-35  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/24/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
06/24/2026
07/01/2026
IV
1.5g
Q8
Infected Wound, Left Toe
Checking Initial Appropriateness 
06/24/2026
MUPIROCIN 2%, 15G (TUBE)
06/24/2026
07/01/2026
TOPICAL
To Affected Area
BID
Pressure Ulcer
Checking Initial Appropriateness 
06/24/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
06/24/2026
07/01/2026
IV
600mg
Q8H
DM FOOT
Checking Initial Appropriateness 
06/28/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
06/28/2026
07/05/2026
IV
2.25
Q6
DM Foot
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: