Dapitan, Jevon R.

HRN: 23-95-61  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/26/2023
AMPICILLIN 1GM (VIAL)
10/26/2023
11/02/2023
IV
195mg
Q12
Neonatal Sepsis
Waiting Final Action 
10/26/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/26/2023
11/02/2023
IV
32mg
Q24
Neonatal Sepsis
Waiting Final Action 

AMS Audit Form


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 Indication:

              

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 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: