Ali, Bb Boy .

HRN: 21-35-50  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)
05/31/2022
06/07/2022
IV
150 Mg
Q12Hrs
Neonatal Pneumonia
Waiting Final Action 
05/30/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
05/31/2022
06/07/2022
IV
15
OD
Neonatal Pneumonia
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: