Tagayan, Baby Girl .

HRN: 28-53-91  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/15/2026
AMPICILLIN 500MG (VIAL)
02/15/2026
02/21/2026
IVT
130mg
Q12
PSNB (PROM X 21 Hours)
Remove - Pending Acceptance
02/15/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/15/2026
02/21/2026
IVT
39
Q24
PSNB (PROM X 21 Hours)
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: