Gumilid, Baby Girl .

HRN: 24-67-20  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/13/2024
AMPICILLIN 250MG (VIAL)
03/13/2024
03/19/2024
IVT
140mg
Q12
Psnb
Waiting Final Action 
03/13/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
03/13/2024
03/19/2024
IVT
14mg
Q24
Psnb
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: