Balansag, Baby Boy .

HRN: 27-66-21  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/29/2025
AMPICILLIN 500MG (VIAL)
08/29/2025
09/05/2025
IV
145mg
Q12H
Neonatal Sepsis
Checking Initial Appropriateness 
08/29/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
08/29/2025
09/05/2025
IV
43mg
Q24H
Neonatal Sepsis
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: