Tambong, Bb Girl .

HRN: 27-76-45  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/07/2025
AMPICILLIN 1GM (VIAL)
09/07/2025
09/14/2025
IV
120mg
Q12h
PSNB, T/C Neonatal Pneumonia
Checking Initial Appropriateness 
09/07/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
09/07/2025
09/14/2025
IV
12mg
Q24
PSNB, T/C Neonatal Pneumonia
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: