Pañares, Baby Boy .

HRN: 23-34-76  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/21/2023
AMPICILLIN 250MG (VIAL)
07/21/2023
07/28/2023
IV
130
BID
PROM X 24hrs
Checking Final Appropriateness 
07/21/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/21/2023
07/28/2023
IV
30mg
OD
PROM X 20hrs
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: