Villalon, Baby Girl C.

HRN: 23-01-63  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/11/2023
AMPICILLIN 1GM (VIAL)
05/11/2023
05/18/2023
IV
95mg
Q12hrs
Non Institutional Delivery
Waiting Final Action 
05/11/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
05/11/2023
05/18/2023
IV
9.5mg
OD
Non Institutional Delivery
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: