Bongcawil, Baby Boy .

HRN: 28-62-67  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/27/2026
AMPICILLIN 250MG (VIAL)
02/27/2026
03/06/2026
170MG
IV
Q12
PSNB
Remove - Pending Acceptance
02/27/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/27/2026
03/06/2026
IV
40mg
Q24
PSNB
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: