Mahinay, Baby Girl .

HRN: 23-95-04  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/23/2023
AMPICILLIN 250MG (VIAL)
10/23/2023
10/29/2023
IVT
100mg
Q12
Prophylaxis
Checking Final Appropriateness 
10/23/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/23/2023
10/29/2023
IVT
30mg
Q24
Prophylaxis
Checking Final Appropriateness 
10/23/2023
ERYTHROMYCIN 0.5%, 3.5G EYE OINTMENT (TUBE)
10/23/2023
10/23/2023
TOPICAL
1squirt
Now
Prophylaxis
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: