Calib-og, Baby Girl .

HRN: 21-26-91  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/25/2022
AMPICILLIN 500MG (VIAL)
06/25/2022
07/02/2022
IV
155 Mg
Q12
PSNB
Waiting Final Action 
06/25/2022
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/25/2022
07/02/2022
IV
37mg
OD
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: