Guinandal, Baby Boy .

HRN: 27-84-74  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/30/2025
AMPICILLIN 500MG (VIAL)
10/01/2025
10/07/2025
IVT
190mg
Q12
PSNB
Waiting Final Action 
10/01/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
10/01/2025
10/07/2025
IVT
19mg
Q24
PSNB
Waiting Final Action 

AMS Audit Form


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Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: