Jabasa, Baby Boy .

HRN: 28-15-40  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
01/13/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
01/13/2026
01/20/2026
IV
390MG
Q6
PCAP C
Checking Initial Appropriateness 
01/14/2026
CEFTRIAXONE 1G (VIAL)
01/14/2026
01/21/2026
IV DRIP IN 1 HOUR
520mg
Q12h
PCAP-C
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: