Balat, Baby Boy .

HRN: 25-76-71  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/07/2024
AMPICILLIN 250MG (VIAL)
09/07/2024
09/14/2024
IV
145mg
Q12H
T/C Neonatal Sepsis
Waiting Final Action 
09/07/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
09/07/2024
09/14/2024
IV
15mg
Q24H
T/C Neonatal 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: