Salisig, Baby Girl .

HRN: 26-94-07  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/07/2025
AMPICILLIN 250MG (VIAL)
04/07/2025
04/13/2025
IV
175mg
Q12
Acute Bacterial Infection (Thickly Msaf)
Waiting Final Action 
04/07/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
04/07/2025
04/13/2025
IV
17.5mg
Q24
Acute Bacterial Infection(thickly Msaf)
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: