Francisco, Baby Boy .

HRN: 27-78-75  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/18/2025
AMPICILLIN 250MG (VIAL)
09/18/2025
09/25/2025
IV
135mg
Q12
PSNB (PROM X 2days)
Waiting Final Action 
09/18/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
09/18/2025
09/25/2025
IV
35mg
Q24
PSNB (PROM X 2days)
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: