Pangontapan, Baby Girl .

HRN: 22-71-79  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
03/19/2023
AMPICILLIN 1GM (VIAL)
03/19/2023
03/26/2023
IVTT
180mg
OD
T/C Neonatal Sepsis
Waiting Final Action 
03/19/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
03/19/2023
03/26/2023
IVTT
18
OD
T/C Neonatal Sepsis
Waiting Final Action 
08/10/2023
AMPICILLIN 250MG (VIAL)
08/10/2023
08/16/2023
IV
170
Q6
Pcap C
Checking Final 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: