Solidum, Lexah Daine Faith E.

HRN: 21-35-19  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/03/2022
AMPICILLIN 500MG (VIAL)
06/03/2022
06/09/2022
IV
200mg
Q12
T/c Neonatal Sepsis
Waiting Final Action 
06/03/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
06/03/2022
06/09/2022
IV
20mg
OD
T/c Neonatal Sepsis
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: