Wisan, Baby Girl .

HRN: 27-78-20  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/12/2025
AMPICILLIN 250MG (VIAL)
09/12/2025
09/19/2025
IV
145mg
Q12h
PSNB
Checking Initial Appropriateness 
09/12/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
09/12/2025
09/19/2025
IV
15mt
Q24h
PSNB
Checking Initial Appropriateness 
09/20/2025
CEFOTAXIME 500MG (VIAL)
09/20/2025
09/27/2025
IV
145mg
Q12
Spesis Pneumonia
Waiting Final Action 
09/20/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
09/20/2025
09/27/2025
IV
40mg
Q24
Sepsis Neonatorum
Waiting Final Action 
09/22/2025
CEFAZOLIN 1GM (VIAL)
09/22/2025
09/28/2025
IVTT
72mg
Q8
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: