Macareal, Jenefe B.

HRN: 23-43-18  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/27/2023
AMPICILLIN 1GM (VIAL)
07/27/2023
08/02/2023
IVTT
105mg
Q12
Potentially Septic Newborn
Checking Final Appropriateness 
07/27/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
07/27/2023
08/02/2023
10.5MG
10.5mg
Q24h
Potentially Septic Newborn
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: