Pamaybay, Bb Boy .

HRN: 28-37-06  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/02/2026
AMPICILLIN 500MG (VIAL)
01/02/2026
01/09/2026
IV
110 Mg
Q12hrs
Neonatal Pneumonia
Checking Final Appropriateness 
01/02/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
01/02/2026
01/09/2026
IV
11 Mg
Q24hrs
Neonatal Pneumonia
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: