Collamat, Baby Boy .

HRN: 28-92-53  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/03/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
05/03/2026
05/09/2026
IVT
17mg
Q24H
NAMF (Maternal UTI; Maternal URTI)
Remove - Pending Acceptance
05/03/2026
AMPICILLIN 250MG (VIAL)
05/03/2026
05/09/2026
IVT
165mg
Q12H
NAMF (Maternal UTI; Maternal URTI)
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: