Buenavista, Baby Boy .

HRN: 27-15-46  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/24/2025
AMPICILLIN 250MG (VIAL)
05/24/2025
05/30/2025
IVT
115mg
Q12
Sepsis
Remove - Pending Acceptance
05/24/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/24/2025
05/30/2025
IVT
33mg
OD
Sepsis
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: