Villa, Baby Boy .

HRN: 23-17-02  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/08/2023
AMPICILLIN 250MG (VIAL)
06/08/2023
06/14/2023
IV
135
Q12
Sepsis Neonatarum
Waiting Final Action 
06/08/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
06/08/2023
06/14/2023
IV
14mg
Q24
Sepsis Neonatarum
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: