Malindang, Baby Boy .

HRN: 26-94-34  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/09/2025
AMPICILLIN 500MG (VIAL)
04/09/2025
04/16/2025
INTRAVENOUS
150 Mg IVTT
Every 12 Hours
PSNB
Waiting Final Action 
04/09/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/09/2025
04/16/2025
INTRAVENOUS
45 Mg IVTT
Every 24 Hours
PSNB
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: