Mancha, Baby Boy .

HRN: 27-27-35  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/22/2025
AMPICILLIN 250MG (VIAL)
06/22/2025
06/29/2025
IV
170mg
Q 12
T/C Neonatal Pneumonia Vs RDS
Remove - Pending Acceptance
06/22/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/22/2025
06/29/2025
IV
50 Mg
Q 24
T/C Neonatal Pneumonia
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: