Gallobe, Baby Boy .

HRN: 21-57-96  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/20/2022
AMPICILLIN 1GM (VIAL)
09/20/2022
09/27/2022
IVTT
130mg
Q12
Psnb
Waiting Final Action 
09/20/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
09/20/2022
09/27/2022
IVTT
13mg
Q24
Psnb
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: