Maito, Nasheed A.

HRN: 27-59-19  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/03/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
08/03/2025
08/10/2025
IV
21mg
Q24hours
Neonatal Sepsis
Checking Initial Appropriateness 
08/03/2025
AMPICILLIN 250MG (VIAL)
08/03/2025
08/10/2025
IV
70mg
Q12hours
Neonatal Sepsis
Checking Initial Appropriateness 
03/06/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
03/06/2026
03/13/2026
IV DRIP
250mg
Q6
PCAP-C
Checking Initial Appropriateness 
03/06/2026
CEFTRIAXONE 1G (VIAL)
03/06/2026
03/12/2026
IV DRIP
450mg
Q24
PCAP-C
Checking Initial Appropriateness 

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: