Ito, Baby Boy .

HRN: 27-72-56  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/04/2025
AMPICILLIN 500MG (VIAL)
09/04/2025
09/11/2025
IVT
145 Mg
Q12h
Meconium Aspiration Syndrome
Checking Initial Appropriateness 
09/04/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
09/04/2025
09/11/2025
IVT
45 Mg
Q24
Meconium Aspiration Syndrome
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: