Canonigo, Baby Boy L.

HRN: 27-27-27  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/19/2025
AMPICILLIN 250MG (VIAL)
06/19/2025
06/26/2025
IV
165 Mg
Q 12
PSNB
Checking Initial Appropriateness 
06/19/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
06/19/2025
06/26/2025
IV
15 Mg
Q 24
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: