Daniel, Baby Boy .

HRN: 28-92-17  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/27/2026
AMPICILLIN 1GM (VIAL)
04/27/2026
05/04/2026
IV
150mg
12h
Neonatal Sepsis
Checking Initial Appropriateness 
04/27/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/27/2026
05/04/2026
IV
40mg
Q24h
Neonatal Sepsis
Checking Initial Appropriateness 
04/28/2026
CEFTAZIDIME 1GM (VIAL)
04/28/2026
05/05/2026
IV
150mg
Q12
PSNB
Checking Initial Appropriateness 
05/01/2026
AMPICILLIN 250MG (VIAL)
05/01/2026
05/08/2026
IVTT
150mg
Q12h
Neonatal Sepsis
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: