Caballero, Baby Girl .

HRN: 22-41-53  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/31/2022
AMPICILLIN 500MG (VIAL)
12/31/2022
01/06/2023
IV
135mg
Q12
PSNB
Waiting Final Action 
12/31/2022
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
12/31/2022
01/06/2023
IV
32mg
Q24
PSNB
Waiting Final Action 

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: