Baby Boy, Butandres .

HRN: 24-00-18  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/15/2023
AMPICILLIN 1GM (VIAL)
11/15/2023
11/21/2023
IVT
175mg
Q12
Psnb
Checking Final Appropriateness 
11/15/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
11/15/2023
11/21/2023
IVT
17.5
Q24
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: