Requilme, Perlita L.

HRN: 14-04-15  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/15/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
08/15/2026
08/21/2026
IV
600mg
Q6
Infected Wound
Remove - Pending Acceptance
08/16/2026
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
08/16/2026
08/22/2026
IV
4g
Q8
Cap Hr
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: