Canlubo, Baby Boy .

HRN: 26-97-93  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/19/2025
AMPICILLIN 500MG (VIAL)
07/19/2025
07/25/2025
IV
145mg
Q12h
PSNB
Waiting Final Action 
07/19/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/19/2025
07/25/2025
IV
42mg
IV
PSNB
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: