Balolong, Baby Boy .

HRN: 29-25-06  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
06/30/2026
AMPICILLIN 250MG (VIAL)
06/30/2026
07/07/2026
IV
110mg
Q24H
T/c Sepsis
Remove - Pending Acceptance
06/30/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
06/30/2026
07/07/2026
IV
24mg
IVTT
Q24H
Remove - Pending Acceptance

AMS Audit Form


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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: