Nardo, Baby Girl .

HRN: 25-13-72  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/22/2024
AMPICILLIN 1GM (VIAL)
05/22/2024
05/28/2024
IV
170mg
Q12
PNSB
Waiting Final Action 
05/22/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/22/2024
05/28/2024
IV
51mg
Q24
PNSB
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: