Cadorna, Baby Boy .

HRN: 28-53-36  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/06/2026
AMPICILLIN 500MG (VIAL)
02/06/2026
02/12/2026
IVT
125mg
Q12
Neonatal Pneumonia
Checking Initial Appropriateness 
02/06/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
02/06/2026
02/12/2026
IVT
13mg
Q24
Neonatal Pneumonia
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: