Hapitan, Baby Boy V.

HRN: 24-32-49  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/28/2024
AMPICILLIN 250MG (VIAL)
03/28/2024
04/04/2024
IV
145mg
Q12H
PSNB
Waiting Final Action 
03/28/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
03/28/2024
04/04/2024
IV
43mg
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: