Dingding, Baby Girl .

HRN: 26-06-53  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/25/2024
AMPICILLIN 250MG (VIAL)
10/25/2024
11/01/2024
IV
140mg
Q12
PSNB
Waiting Final Action 
10/25/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/25/2024
11/01/2024
IV
35mg
Q24
PSNB
Waiting Final Action 
10/25/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/25/2024
11/01/2024
IV
35mg
Q24
PSNB
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: