Tibor, Baby Boy .

HRN: 27-24-60  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/09/2025
AMPICILLIN 250MG (VIAL)
06/09/2025
06/15/2025
IVT
125mg
Q12
T/C Neonatal Pneumonia
Checking Initial Appropriateness 
06/09/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
06/09/2025
06/15/2025
IVT
13mg
Q24
T/C Neonatal Pneumonia
Checking Initial Appropriateness 
06/20/2025
CEFOTAXIME 500MG (VIAL)
06/20/2025
07/07/2025
IV
85mg
Q8
PSNB
Checking Initial Appropriateness 
06/20/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/20/2025
06/27/2025
IV
35mg
Q24
PSNB
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: