Dela Cruz, Baby Boy .

HRN: 22-87-98  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/20/2023
AMPICILLIN 250MG (VIAL)
04/20/2023
04/26/2023
IV
85mg
Q12Hrs
Prematurity
Waiting Final Action 
04/20/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
04/20/2023
04/26/2023
IV
8mg
Q36H
Prematurity
Waiting Final Action 
04/20/2023
ERYTHROMYCIN 0.5%, 3.5G EYE OINTMENT (TUBE)
04/20/2023
04/21/2023
TOPICAL
Single
Once
Prematurity
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: