Mama, Bb Girl .

HRN: 27-08-79  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
05/15/2025
IVTT
140mg
Q12 Hours
PSNB
Waiting Final Action 
05/08/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/08/2025
05/15/2025
IVTT
42mg
Q24hours
PSNB
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: