Malalis, John Michael R.

HRN: 22-01-22  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/25/2022
AMPICILLIN 250MG (VIAL)
09/25/2022
10/02/2022
IV
140mg
Q12
Potentially Septic Newborn (Thinly Msaf)
Waiting Final Action 
09/25/2022
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
09/25/2022
10/02/2022
IV
42mg
Q24h
Potentially Septic Newborn (Thinly Msaf)
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: