Ongue, Bb Boy .

HRN: 21-26-77  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/10/2022
AMPICILLIN 500MG (VIAL)
06/10/2022
06/16/2022
IVT
280
Q12 For 7 Days
MSAF
06/10/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
06/10/2022
06/16/2022
IVT
14mg
Q24 For 7 Days
Msaf
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: