Orungan, Macy Kim S.

HRN: 23-05-76  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/28/2023
AMPICILLIN 250MG (VIAL)
06/28/2023
07/05/2023
IV
150mg
Q12
Potential Septic Newborn
Waiting Final Action 
06/28/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/05/2023
06/28/2023
IV
30mg
Q24h
Potential Septic Newborn
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: