Gioca, Baby Boy G.

HRN: 22-81-72  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/02/2023
AMPICILLIN 500MG (VIAL)
04/02/2023
04/09/2023
IV
150mg
Q12
Septicemia
Waiting Final Action 
04/02/2023
AMIKACIN 250MG/ML, 2ML (VIAL/AMP)
04/02/2023
04/09/2023
IV
35mg
OD
Septicemia
Waiting Final Action 
04/02/2023
ERYTHROMYCIN 0.5%, 3.5G EYE OINTMENT (TUBE)
04/02/2023
04/02/2023
OPHTHALMIC
.5 % OU
Once Only
Prophylaxis
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: