Rabaca, Saharish P.

HRN: 29-23-88  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
07/03/2026
AMPICILLIN 1GM (VIAL)
07/03/2026
07/10/2026
IV
130mg
Q12H
T/c Neonatal Sepsis
Remove - Pending Acceptance
07/03/2026
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
07/03/2026
07/10/2026
IV
39mg
Q24H
T/c Neonatal Sepsis
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: