Aguilar, Baby Boy T.

HRN: 24-59-65  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/05/2024
AMPICILLIN 250MG (VIAL)
03/05/2024
03/12/2024
IV
100mg
Q12hours
RDS Sec To Prematurity
Waiting Final Action 
03/05/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
03/05/2024
03/12/2024
IV
10mg
OD
RDS Sec To Prematurity
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: