Lopez, Baby Boy .

HRN: 29-04-00  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/20/2026
AMPICILLIN 250MG (VIAL)
05/20/2026
05/27/2026
IV
85mg
Q12h
Neonatal Sepsis
Checking Initial Appropriateness 
05/20/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
05/20/2026
05/27/2026
IV
8mg
Q36h
Neonatal Sepsis
Checking Initial Appropriateness 
05/24/2026
CEFTAZIDIME 1GM (VIAL)
05/24/2026
05/31/2026
IV
51mg
Q12
NEONATAL SEPSIS
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: