Jaji, Baby Boy .

HRN: 28-09-45  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
11/17/2025
AMPICILLIN 250MG (VIAL)
11/17/2025
11/24/2025
IV
140mg
Q 12
PSNB
Checking Final Appropriateness 
11/17/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
11/17/2025
11/24/2025
IV
42 Mg
Q 24
PSNB
Checking Final 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: