Got, Baby Girl -.

HRN: 27-84-36  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/26/2025
AMPICILLIN 250MG (VIAL)
09/26/2025
10/03/2025
IV
120mg
Q12H
PSNB
Checking Initial Appropriateness 
09/26/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
09/26/2025
10/03/2025
IV
36mg
Q24H
PSNB
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: