Ugmad, Bb Boy .

HRN: 24-10-23  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/14/2023
AMPICILLIN 500MG (VIAL)
11/14/2023
11/21/2023
IV
170mg
Q12
PSNB
Checking Final Appropriateness 
11/14/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
11/14/2023
11/21/2023
IV
17mg
Q24h
PSNB
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: