Ursonal, Baby Boy .

HRN: 28-59-06  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/18/2026
AMPICILLIN 250MG (VIAL)
02/18/2026
02/25/2026
IV
165 Mg
Q 12
PSNB; T/C MAP
Remove - Pending Acceptance
02/18/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/18/2026
02/25/2026
IV
50 Mg
Q 24
PSNB; T/C MAP
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: