Rañola, Bb Boy V.

HRN: 23-76-16  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/30/2023
AMPICILLIN 250MG (VIAL)
09/30/2023
10/06/2023
IV
110mg
Q12h
Potentially Septic Newborn
Waiting Final Action 
09/30/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
09/30/2023
10/06/2023
IV
33mg
OD
Potentially Septic Newborn
Waiting Final Action 

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: