Eusebio, Bb Girl .

HRN: 29-25-26  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/01/2026
AMPICILLIN 250MG (VIAL)
07/01/2026
07/07/2026
IV
135mg
Q12
Neonatal Pneumonia
Remove - Pending Acceptance
07/01/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
07/01/2026
07/07/2026
IV
13.5mg
Q24
Neonatal Pneumonia
Remove - Pending Acceptance
07/01/2026
ERYTHROMYCIN 0.5%, 3.5G EYE OINTMENT (TUBE)
07/01/2026
07/01/2026
OPHTHALMIC
As Needed
Once
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: