Cabayacruz, Baby Boy .

HRN: 28-73-04  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/23/2026
AMPICILLIN 250MG (VIAL)
03/23/2026
03/30/2026
IV
130mg
Q12
Omphalitis
Remove - Pending Acceptance
03/23/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
03/23/2026
03/30/2026
IV
30mg
Q24
Omphalitis
Remove - Pending Acceptance
03/23/2026
MUPIROCIN 2%, 15G (TUBE)
03/23/2026
03/30/2026
TOPICAL
15g
TID
Omphalitis
Remove - Pending Acceptance

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: