Banagan, Mutasim T.

HRN: 21-59-85  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/20/2022
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
07/20/2022
07/20/2022
IV
230mg
Q8h
Neonatal Pneumonia
Waiting Final Action 
07/20/2022
AMPICILLIN 1GM (VIAL)
07/20/2022
07/27/2022
IVTT
175mg
Q12h
Pcap
Waiting Final Action 
07/20/2022
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/20/2022
07/27/2022
IVTT
35mg
Q24
Pcap
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: