Naong, Baby Boy .

HRN: 23-05-20  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/29/2023
AMPICILLIN 250MG (VIAL)
05/29/2023
06/05/2023
IVT
125mg
Q12
Sepsis
Checking Final Appropriateness 
05/29/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/29/2023
06/05/2023
IVT
37mg
Q24
Sepsis
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: