Bogol, Baby Girl .

HRN: 27-78-39  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/13/2025
AMPICILLIN 500MG (VIAL)
09/13/2025
09/19/2025
IVT
175mg
Q12H
T/C Neonatal Pneumonia
Checking Initial Appropriateness 
09/13/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
09/13/2025
09/19/2025
IVT
7.5mg
Q24H
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: