Tocles, Baby Girl .

HRN: 28-92-90  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/08/2026
AMPICILLIN 250MG (VIAL)
05/08/2026
05/15/2026
IV
140mg
Q12h
NAMF MATERNAL UTI
Checking Initial Appropriateness 
05/08/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
05/08/2026
05/15/2026
IV
14mg
Q24
NAMF MATERNAL UTI
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: