Camad, Baina C.

HRN: 28-94-77  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/29/2026
AMPICILLIN 250MG (VIAL)
04/29/2026
05/06/2026
IV
150 Mg
Q 6 Hours
Bacterial Skin Infection
Remove - Pending Acceptance
04/29/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/29/2026
05/06/2026
IV
25mg
Q 8 Hours
Bacterial Skin Infection
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: