Salinas, Baby Boy R.

HRN: 21-22-61  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/30/2022
AMPICILLIN 250MG (VIAL)
05/30/2022
06/05/2022
IVT
230mg
Q6
Pneumonia
Waiting Final Action 
05/30/2022
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/30/2022
06/05/2022
IVT
55mg
OD
Pneumonia
Waiting Final Action 
06/04/2022
MUPIROCIN 2%, 15G (TUBE)
06/04/2022
06/10/2022
APPLY ON RASHES
2x A Day
Apply 2x A Day
Pruritic Rash On IV Site
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: