Jacosalem, Baby Girl .

HRN: 26-16-41  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/02/2024
AMPICILLIN 250MG (VIAL)
11/02/2024
11/09/2024
INTRAVENOUS
65 Mg IVTT
Every 12 Hours
PSNB
Waiting Final Action 
11/02/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
11/02/2024
11/09/2024
INTRAVENOUS
24 Mg IVTT
Every 48 Hours
PSNB
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: