Jemino, Baby Boy .

HRN: 22-13-31  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/26/2022
AMPICILLIN 250MG (VIAL)
10/26/2022
11/02/2022
IV
160mg
Q12
Potentially Septic Newborn (Thickly Msaf)
Waiting Final Action 
10/26/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
10/26/2022
11/02/2022
IV
15mg
Q24h
Potentially Septic Newborn (Thickly Msaf)
Waiting Final Action 

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: