Ontolan, Bb Boy .

HRN: 26-69-86  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/04/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
03/04/2025
03/10/2025
IV
42mg
Q24
Acute Bacterial Infection
Waiting Final Action 
03/04/2025
AMPICILLIN 250MG (VIAL)
03/04/2025
03/10/2025
IV
175mg
Q12
Acute Bacterial Infection
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: