Bautista, Baby Boy .

HRN: 24-06-42  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/04/2023
AMPICILLIN 250MG (VIAL)
12/04/2023
12/10/2023
IVT
70 Mg
Q12
Psnb,preterm
Checking Final Appropriateness 
12/04/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
12/04/2023
12/10/2023
IVT
7mg
Od
Preterm,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: