Boltiador, Baby Boy 2 .

HRN: 27-24-46  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/06/2025
AMPICILLIN 250MG (VIAL)
06/06/2025
06/13/2025
IVT
120mg
Q12
T/C Neonatal Pneumonia
Checking Initial Appropriateness 
06/06/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
06/06/2025
06/13/2025
IVT
12mg
Q24
T/C Neonatal Pneumonia
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: