Diabo, Baby Boy .

HRN: 25-15-90  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/14/2024
AMPICILLIN 1GM (VIAL)
06/14/2024
06/21/2024
IVTT
180
Q12
UTI
Waiting Final Action 
06/14/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
06/14/2024
06/21/2024
IV
18
Q24
UTI
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: