Miel, Baby Boy .

HRN: 26-58-20  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/07/2025
AMPICILLIN 500MG (VIAL)
02/07/2025
02/13/2025
IVT
200mg
Q12
PROM X 3 Days
Waiting Final Action 
02/07/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
02/07/2025
02/13/2025
IVT
20mg
OD
PROM X 3 Days
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: