Gajo, Baby Girl .

HRN: 29-18-20  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/17/2026
AMPICILLIN 250MG (VIAL)
06/17/2026
06/23/2026
IV
155mg
Q12
T/C MAS
Remove - Pending Acceptance
06/17/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/17/2026
06/23/2026
IV
46mg
OD
T/C MAS
Remove - Pending Acceptance
06/17/2026
ERYTHROMYCIN 0.5%, 3.5G EYE OINTMENT (TUBE)
06/17/2026
06/17/2026
TOPICAL
Pea Size
OD
Eye Prophylaxis
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: