Garcines, Josephine D.

HRN: 29-50-08  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/18/2026
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
08/18/2026
08/25/2026
IV
2.25grams
Every 8hrs
Nonhealing Wound, Right Leg
Remove - Pending Acceptance
08/18/2026
CLINDAMYCIN 150MG/ML, 4ML (AMP)
08/18/2026
08/25/2026
IV
600mg
Every 8hrs
Nonhealing Wound, Right Leg
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: