Wagas, Luciano, Sr. C.

HRN: 22-45-30  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/03/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/03/2023
01/10/2023
IV
1.5
Q6
Infected Wound
Waiting Final Action 
01/03/2023
CLINDAMYCIN 150MG/ML, 4ML (AMP)
01/03/2023
01/10/2023
IV
600mg
Q8
Infected Wound
Waiting Final Action 
01/03/2023
MUPIROCIN 2%, 15G (TUBE)
01/03/2023
01/10/2023
TOPICAL
2%
TID
Infected Wound
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: