Matigas, Jonard, Jr. R.

HRN: 25-15-71  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/06/2024
AMPICILLIN 500MG (VIAL)
07/06/2024
07/13/2024
IV
200mf
Q6hours
T/c Neonatal Pneumonia
Waiting Final Action 
07/06/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
07/06/2024
07/13/2024
IV
22mg
Q24hours
T/c Neonatal Pneumonia
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: