Catalio, Bb Girl .

HRN: 28-53-20  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/03/2026
AMPICILLIN 250MG (VIAL)
02/03/2026
02/09/2026
IV
150mg
Q12
MAP
Checking Initial Appropriateness 
02/03/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/03/2026
02/09/2026
IV
45mg
Q24
MAP
Checking Initial Appropriateness 
02/06/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
02/06/2026
02/13/2026
IVT
45mg LD; 22mg
Q24
Necrotizing Enterocolitis
Checking Initial 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: