Tuburan, Baby Boy .

HRN: 26-96-92  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/16/2025
AMPICILLIN 250MG (VIAL)
04/16/2025
04/22/2025
IV
60mg
Q12
Sepsis Neonatorum
Waiting Final Action 
04/16/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
04/16/2025
04/22/2025
IV
5.4mg
Q36 Hours
Sepsis Neonatorum
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: