Tagaloguin, Baby Girl .

HRN: 28-84-36  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
04/23/2026
IV
100mg
Q12
Sepsis
Checking Initial Appropriateness 
04/16/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
04/16/2026
04/23/2026
IV
4mg
Q24
Sepsis
Checking Initial Appropriateness 
04/20/2026
FLUCONAZOLE 2MG/ML, 100ML (VIAL)
04/20/2026
04/27/2026
IV
23mg As Loading Dose, Then 11mg
One Dose As Loading Dose, Then Q24H
T/C TTN; T/C Neonatal Pneumonia
Checking Initial Appropriateness 
04/21/2026
METRONIDAZOLE 5MG/ML, 100ML (VIAL)
04/21/2026
04/28/2026
IV
30mg Loading Dose Then 14mg
Q8hrs
T/C Neonatal Sepsis
Checking Initial Appropriateness 

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: