Georpe, Baby Boy .

HRN: 21-89-27  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/13/2022
AMPICILLIN 250MG (VIAL)
09/13/2022
09/20/2022
IV
137mg
Q12
Neonatal Sepsis
Waiting Final Action 
09/13/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
09/13/2022
09/20/2022
IV
14mg
Q24
Neonatal Sepsis
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: