Unding, Baby Girl .

HRN: 22-39-92  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/24/2023
AMPICILLIN 1GM (VIAL)
02/24/2023
03/03/2023
IV
115mg
BID
Empiric
Waiting Final Action 
02/24/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
02/24/2023
03/03/2023
IV
35mg
OD
Empiric
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: