Baby Boy, Dalansay .

HRN: 29-04-11  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/21/2026
AMPICILLIN 250MG (VIAL)
05/21/2026
05/27/2026
IV
63
Q8
SEPSIS
Remove - Pending Acceptance
05/21/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
05/21/2026
05/26/2026
IV
15MG
OD
SEPSIS
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: