Baay, Baby Boy T.

HRN: 26-61-76  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/28/2025
AMPICILLIN 250MG (VIAL)
01/28/2025
02/04/2025
IV
230mg
Q12H
PCAP C
Waiting Final Action 
01/28/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
01/28/2025
02/04/2025
IV
69mg
Q24H
PCAP C
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: