Mandeg, Chelly G.

HRN: 23-05-53  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/18/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/18/2023
06/25/2023
IVTT
45mg
OD
Newborn Affected By Maternal Factors (Maternal UTI)
Waiting Final Action 
06/18/2023
AMPICILLIN 1GM (VIAL)
06/18/2023
06/25/2023
IVTT
165mg
Q12
Newborn Affected By Maternal Factors (Maternal UTI)
Waiting Final Action 
04/17/2024
AMPICILLIN 500MG (VIAL)
04/17/2024
04/24/2024
IV
300mg
Q6H
PCAP C
Waiting Final Action 
04/17/2024
AMPICILLIN 500MG (VIAL)
04/17/2024
04/24/2024
IV
300mg
Q6h
PCAP C
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: