Muyco, Baby Girl B.

HRN: 27-27-91  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/30/2025
AMPICILLIN 250MG (VIAL)
06/30/2025
07/07/2025
IV
170mg
Q 12
PSNB
Waiting Final Action 
06/30/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/30/2025
07/07/2025
IV
50 Mg
Q 24
PSNB
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: