Capa, Baby Boy .

HRN: 24-59-55  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/03/2024
AMPICILLIN 250MG (VIAL)
03/03/2024
03/10/2024
IV
150 Mg
Q12 H
Neonatal Sepsis
Waiting Final Action 
03/03/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
03/03/2024
03/10/2024
IV
15 Mg
OD
Neonatal Sepsis
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: