Pasturan, Cymryel Gold .

HRN: 24-94-20  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/10/2024
AMPICILLIN 500MG (VIAL)
04/10/2024
04/16/2024
IV
165mg
Q12h
Late Onset Sepsis
Checking Final Appropriateness 
04/10/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/10/2024
04/16/2024
IV
50mg
Q24h
Late Onset Sepsis
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: