Meraiz, Princess Johana C.

HRN: 20-62-02  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/08/2023
PIPERACILLIN + TAZOBACTAM 4.5G (VLS)
03/08/2023
03/14/2023
IV
4.5g
Q8hours
SLE In Flare
Waiting Final Action 
03/08/2023
MUPIROCIN 2%, 15G (TUBE)
03/08/2023
03/14/2023
TOPICAL
As Needed
TID
SLE In Flare
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: