Delia, Baby Girl .

HRN: 28-23-78  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/10/2025
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
12/10/2025
12/17/2025
IV
335MG
Q6
PCap C
Checking Final Appropriateness 
12/14/2025
GENTAMICIN 40MG/ML, 2ML (AMP)
12/14/2025
12/20/2025
IV
25mg
Q8
PCAP-C
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: