Berano, Bb Girl .

HRN: 27-91-89  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/14/2025
AMPICILLIN 250MG (VIAL)
10/14/2025
10/21/2025
IV DRIP
85mg
Q12h
Psnb
Remove - Pending Acceptance
10/14/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
10/14/2025
10/21/2025
IV DRIP
26mg
Q24h
Psnb
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: