Bonggo, Baby Girl .

HRN: 29-46-85  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/12/2026
AMPICILLIN 1GM (VIAL)
08/12/2026
08/19/2026
IV
118MG
Q12H
PSNB IN TRANSIT DELIVERY
Checking Initial Appropriateness 
08/12/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
08/12/2026
08/19/2026
IV
12MG
Q24
PSNB INTRANSIT DEL
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: