Delloro, Baby Girl .

HRN: 27-07-34  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/08/2025
AMPICILLIN 250MG (VIAL)
05/08/2025
05/14/2025
IV
170mg
Q12
NAMF (Hespes Zoster) Acute Bacterial Infection
Waiting Final Action 
05/08/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
05/08/2025
05/14/2025
IV
17mg
Q24
NAMF (Hespes Zoster); 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: