Pagara, Baby Boy .

HRN: 24-86-69  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/21/2024
AMPICILLIN 1GM (VIAL)
05/21/2024
05/27/2024
IV
200mg
Q12
PNSB
Waiting Final Action 
05/21/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/21/2024
05/27/2024
IV
48mg
Q24
PNSB
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: