Bandahala, Nadzkee .

HRN: 24-38-57  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/13/2024
AMPICILLIN 500MG (VIAL)
01/13/2024
01/19/2024
IV
135mg
Q6h
PCAP C
Checking Final Appropriateness 
01/13/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
01/13/2024
01/19/2024
IV
27mg
OD
PCAP. C
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: