Baby Boy, Taporuc .

HRN: 23-84-89  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/08/2023
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
10/08/2023
10/14/2023
IVT
300mg
Q4
Pcap C
Waiting Final Action 
10/09/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/09/2023
10/15/2023
IV
65mg
OD
Pcap C
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: