Gampongan, Baby Girl .

HRN: 23-43-81  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/06/2023
AMPICILLIN 250MG (VIAL)
08/06/2023
08/13/2023
IV
90 Mg
Every 12 Hours
PSNB
Checking Final Appropriateness 
08/06/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
08/06/2023
08/13/2023
IV
9 Mg
Once Daily
PSNB
Checking Final Appropriateness 

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: