Bariñan, Baby Boy A.

HRN: 27-58-48  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/05/2025
AMPICILLIN 250MG (VIAL)
08/05/2025
08/12/2025
IV
105mg
Q12hours
PSNB Sec To Maternal UTI
Remove - Pending Acceptance
08/05/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
08/05/2025
08/12/2025
IV
11mg
Q24hours
PSNB Sec To Maternal UTI
Remove - Pending Acceptance

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: