Donio, Baby Boy .

HRN: 29-45-66  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
08/16/2026
AMPICILLIN 250MG (VIAL)
08/16/2026
08/23/2026
IV
200mg
Q12H
TTN VS Neonatal Pneumonia
Remove - Pending Acceptance
08/16/2026
GENTAMICIN 40MG/ML, 2ML (AMP)
08/16/2026
08/23/2026
IV
16mg
Q24H
TTN VS Neonatal Pneumonia
Remove - Pending Acceptance

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: