Daligdig, Baby Girl .

HRN: 28-79-37  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/04/2026
AMPICILLIN 250MG (VIAL)
04/04/2026
04/10/2026
IV
120mg
Q12H
Possibly Septics Newborn (PROM X 2 Days)
Remove - Pending Acceptance
04/04/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
04/04/2026
04/10/2026
IV
12mg
Q24h
Possible Septic Newborn (PROM X 24hrs)
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: