Flores, Baby Boy .

HRN: 23-89-09  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/17/2023
AMPICILLIN 250MG (VIAL)
10/17/2023
10/23/2023
IV
120mg
Q12
Potentially Septic
Waiting Final Action 
10/17/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
10/17/2023
10/23/2023
IV
12mg
Od
Potentially Septic
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: