Balios, Baby Girl .

HRN: 27-27-30  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/20/2025
AMPICILLIN 250MG (VIAL)
06/20/2025
06/27/2025
IV
130mg
Q12
TC Aspiration Pneumonia
Remove - Pending Acceptance
06/20/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
06/20/2025
06/27/2025
IV
15mg
Q24
TC Aspiration Pneumonia
Remove - Pending Acceptance

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: