Torejas, Baby Girl .

HRN: 23-77-36  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/24/2023
AMPICILLIN 250MG (VIAL)
09/24/2023
09/30/2023
IV
130mg
Q12
PSNB
Waiting Final Action 
09/24/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
09/24/2023
09/30/2023
IV
13mg
OD
PSNB
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: