Tundi, Baby Girl .

HRN: 24-66-76  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/06/2024
AMPICILLIN 1GM (VIAL)
03/06/2024
03/12/2024
IVT
135mg
Q12
Psnb
Waiting Final Action 
03/06/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
03/06/2024
03/12/2024
IVT
13.5
Od
Psnb
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: