Saitili, Jhonrel A.

HRN: 23-53-26  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/30/2023
AMPICILLIN 500MG (VIAL)
08/30/2023
09/06/2023
IVT
150mg
Q12
Neonatal Sepsis
Waiting Final Action 
08/30/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
08/30/2023
09/06/2023
IVT
30mg
Q24
Neonatal Sepsis
Waiting Final Action 
08/31/2023
CEFTAZIDIME 1GM (VIAL)
08/31/2023
09/06/2023
IV
90mg
Q8
T/C Aspiration 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: