Mateo, Baby Boy .

HRN: 26-37-73  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/19/2024
AMPICILLIN 250MG (VIAL)
12/19/2024
12/26/2024
IVT
175mg
Q12
PSNB
Waiting Final Action 
12/19/2024
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
12/19/2024
12/26/2024
IVT
42mg
Q24
PSNB
Waiting Final Action 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: