Tañola, Baby Girl .

HRN: 28-53-78  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/14/2026
AMPICILLIN 500MG (VIAL)
02/14/2026
02/20/2026
IVT
170mg
Q12
PSNB (PROM X 12 Hours)
Remove - Pending Acceptance
02/14/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/14/2026
02/20/2026
IVT
51mg
Q24
PSNB (PROM X 12 Hours)
Remove - Pending Acceptance

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: