Dapo, Baby Boy .

HRN: 28-99-71  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/15/2026
AMPICILLIN 250MG (VIAL)
05/15/2026
05/22/2026
IV
40mg
Q12hours
Neonatal Sepsis
Checking Initial Appropriateness 
05/15/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
05/15/2026
05/22/2026
IV
4mg
Q48hours
Neonatal Sepsis
Checking Initial Appropriateness 
05/26/2026
FLUCONAZOLE 2MG/ML, 100ML (VIAL)
05/26/2026
07/28/2026
IV
4MG
2X A WEEK
FUNGAL INFECTION
Checking Initial Appropriateness 
05/28/2026
CEFTAZIDIME 1GM (VIAL)
05/28/2026
06/04/2026
IV
40mg
Q12
Neonatal Sepsis
Checking Initial Appropriateness 
05/28/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/28/2026
06/04/2026
IV
16mg
Q36
NEONATAL SEPSIS
Checking Initial Appropriateness 
05/28/2026
CEFTAZIDIME 1GM (VIAL)
05/28/2026
06/03/2026
IV
40mg
Q12
Bacterial Infection
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: