Sanita, Baby Girl .

HRN: 28-31-06  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/22/2025
AMPICILLIN 1GM (VIAL)
12/22/2025
12/29/2025
IV
95mg
Q12H
Neonatal Sepsis
Checking Final Appropriateness 
12/22/2025
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
12/22/2025
12/29/2025
IV
28mg
Q24H
Neonatal Sepsis
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: