Repoldo, Baby Girl R.

HRN: 46  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/09/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
04/09/2022
04/16/2022
IV
15.5mg
Q24h
PNSB; NB Affected By Maternal UTI / Pneumonia
Waiting Final Action 
04/09/2022
AMPICILLIN 250MG (VIAL)
04/09/2022
04/16/2022
IV
155mg
Q12h
PNSB; NB Affected By Maternal UTI / Pneumonia
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: