Palma, Baby Boy .

HRN: 24-06-56  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/15/2023
AMPICILLIN 250MG (VIAL)
12/15/2023
12/22/2023
IV
127mg
Q12
Neonatal Asphyxia
Waiting Final Action 
12/15/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
12/15/2023
12/22/2023
IV
38mg
Q24
Neonatal Asphyxia
Waiting Final Action 
12/15/2023
ERYTHROMYCIN 0.5%, 3.5G EYE OINTMENT (TUBE)
12/15/2023
12/22/2023
OU
1 Gram
Once
Eye Prophylaxis
Waiting Final Action 
12/16/2023
PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)
12/16/2023
01/16/2024
IV
380mg
Q12
Neonatal Sepsis
Waiting Final Action 
12/25/2023
FLUCONAZOLE 2MG/ML, 100ML (VIAL)
12/25/2023
12/26/2023
IVT
15mg
OD
Prophylaxis
Waiting Final Action 
12/30/2023
CIPROFLOXACIN 500MG (TAB)
12/30/2023
01/06/2024
PER OGT
38mg Pptab
BID
Sepsis
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: