Maque, Baby Girl .

HRN: 28-84-22  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/16/2026
AMPICILLIN 250MG (VIAL)
04/16/2026
04/22/2026
IVT
140mg
Q12H
NAMF (PROM X 45 Hours)
Remove - Pending Acceptance
04/16/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
04/16/2026
04/22/2026
IVT
14mg
Q24H
NAMF (PROM X 45 Hours)
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: