Gapor, Baby Boy .

HRN: 25-08-10  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/19/2024
AMPICILLIN 500MG (VIAL)
06/19/2024
06/25/2024
IVT
184mg
Q12
Sepsis
Waiting Final Action 
06/19/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/19/2024
06/25/2024
IVT
55mg
Q24
Sepsis
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: