2017年抗菌药物备案.doc

附件1医疗机构抗菌药物供应目录备案表医疗机构名称： xxxxxxxxxxxxxx （加盖单位公章）分类品种编号通用名品规编号商用名称剂型规格零售价格（元）生产企业 分级备注非限制使用级(共44种)限制使用级(共39种)特殊使用级(共9种)普通青霉素类1青霉素G钠1注射剂80万U0.39xxxxxxx青霉素G钠2注射剂160万U0.63xxxxxxx广谱青霉素2阿莫西林胶囊3阿莫仙胶囊剂0.5g*2420.56xxxxxxx阿莫西林分散片4分散片0.5g*1018.26xxxxxxx3注射用美洛西林钠5力扬注射剂2.0g28.07xxxxxxx6注射剂1.5g22.85xxxxxxx4注射用阿洛西林钠7注射剂1.0g5.89xxxxxxx8注射剂1.5g39.80xxxxxxx5注射用磺苄西林钠9万普健注射剂1.0g33.41xxxxxxx10颇佳注射剂2.0g51.23xxxxxxx对酶稳定的青霉素类6注射用氟氯西林钠11注射剂0.5g38.00xxxxxxx注射用氟氯西林钠12伊芬注射剂1.0g98.77xxxxxxx氟氯西林钠胶囊13胶囊剂0.25g*1239.00xxxxxxx青霉素类复方制剂（-内酰胺酶抑制剂） 7 注射用阿莫西林克拉维酸钾14注射剂0.6g11.57xxxxxxx15君尔清注射剂1.2g14.92xxxxxxx阿莫西林克拉维酸钾片16君尔清片剂375mg*1545.74xxxxxxx8注射用美洛西林/舒巴坦钠17开林注射剂1.25g32.83xxxxxxx18注射剂3.75g80.76xxxxxxx9注射用哌拉西林/他唑巴坦钠19注射剂1.25g69.00xxxxxxx20凯伦注射剂2.25g27.30xxxxxxx10注射用氨苄西林/舒巴坦钠21注射剂2.25g45.68xxxxxxx第一代头孢菌素类11注射用头孢唑林22注射剂0.5g0.85xxxxxxx注射用五水头孢唑林钠23新泰林注射剂1.0g43.65xxxxxxx12头孢羟氨苄胶囊24胶囊剂0.25g*1216.00xxxxxxx头孢羟氨苄咀嚼片25片剂0.125g*167937xxxxxxx13注射用头孢西酮26注射剂0.5g143.00xxxxxxx27注射剂1.0g230.00xxxxxxx14注射用头孢硫脒28仙力素注射剂0.5g27.79xxxxxxx29仙力素注射剂1.0g46.86xxxxxxx第二代头孢菌素类15注射用头孢呋辛钠30明可欣注射剂0.75g25.74xxxxxxx注射用头孢呋辛钠31安可欣注射剂1.5g44.61xxxxxxx头孢呋辛酯分散片32库欣片剂0.125g*1227.90xxxxxxx16头孢克洛胶囊33胜寒胶囊剂0.25g*613.70xxxxxxx17注射用盐酸头孢替安34注射剂0.25g15.03xxxxxxx注射用盐酸头孢替安35注射剂1.0g35.67xxxxxxx18头孢丙烯分散片36银力舒分散片0.25g*630.76xxxxxxx头孢丙烯胶囊37亿代胶囊剂0.25g*620.51xxxxxxx第三、四代头孢菌素类19注射用头孢曲松钠38罗氏芬注射剂0.5g33.56xxxxxxx39罗氏芬注射剂1.0 g57.13xxxxxxx20注射用头孢哌酮钠40注射剂0.5g18.00xxxxxxx21注射用头孢噻肟钠41注射剂0.5g30.00xxxxxxx欧盟认证42立健帅注射剂1g51.00xxxxxxx欧盟认证22注射用头孢唑肟钠43益保世灵注射剂1g59.70xxxxxxx日本23注射用头孢他啶44注射剂0.5g22.63xxxxxxx45注射剂1g37.90xxxxxxx24注射用盐酸头孢吡肟46信力威注射剂0.5g18.93xxxxxxx头孢菌素复方制剂（-内酰胺酶抑制剂）25注射用头孢哌酮/舒巴坦钠47舒普深注射剂1.5g69.30xxxxxxx48汕鮀宁注射剂2g17.76xxxxxxx头霉素类26注射用头孢西丁钠50噻欧注射剂1g17.05xxxxxxx注射用头孢米诺钠51注射剂1g36.09xxxxxxx其他内酰胺类27法罗培南片52君迪片剂0.25g*6129.92xxxxxxx28注射用拉氧头孢53噻吗灵注射剂1g100.87xxxxxxx54注射剂0.5g39.51xxxxxxx碳青霉烯类29注射用亚胺培南西司他丁钠55联邦倍能安注射剂0.25g:0.25g51.76xxxxxxx56泰能注射剂1g135.31xxxxxxx30注射用比阿培南57天册注射剂0.3g130.95xxxxxxx大环内酯类31阿奇霉素肠溶胶囊58胶囊剂0.25g*635.65xxxxxxx阿奇霉素肠溶片59肠溶片0.25g*1221.14xxxxxxx阿奇霉素干混悬剂60混悬剂0.1g*638.00xxxxxxx注射用阿奇霉素61其仙注射剂0.125g19.93xxxxxxx注射用阿奇霉素62其仙注射剂0.25g34.14xxxxxxx32红霉素肠溶胶囊63美红胶囊剂0.25g*1629.25xxxxxxx注射用乳糖酸红霉素64注射剂0.25g0.92xxxxxxx33罗红霉素缓释胶囊65逻施立胶囊剂0.15g*1237.40xxxxxxx林可酰胺类34盐酸克林霉素注射液66莱美特宁注射剂4ml:0.3g22.50xxxxxxx注射用盐酸克林霉素67注射剂0.5g33.75xxxxxxx氨基糖苷类35硫酸阿米卡星注射液68注射剂2ml：0.2g1.08xxxxxxx36硫酸依替米星注射液69硫酸依替米星注射液注射剂4ml：0.2g74.70xxxxxxx硫酸依替米星注射液70注射剂2ml：0.1g38.69xxxxxxx四环素类37注射用替加环素71天解注射剂50mg518.70xxxxxxx喹诺酮类38盐酸环丙沙星片72片剂0.5g*1015.00xxxxxxx注射用盐酸环丙沙星73注射剂0.2g5500xxxxxxx39吡哌酸74片剂0.25g*10016.80xxxxxxx40左氧氟沙星片75可乐必妥片剂0.1g*1035.22xxxxxxx乳酸左氧氟沙星注射液76来立信注射剂0.3g30.14xxxxxxx盐酸左氧氟沙星注射液77左克注射剂0.1g:2ml9.90xxxxxxx41盐酸莫西沙星氯化钠注射液78拜复乐注射剂250ml：0.4g253.27xxxxxxx盐酸莫西沙星注射液79注射剂0.4g:20ml198.50xxxxxxx糖肽类42注射用盐酸万古霉素80注射剂0.5g78.87xxxxxxx硝基咪唑衍生物43甲硝唑片81片剂0.2g*10037.14xxxxxxx甲硝唑氯化钠注射液82注射剂250ml*0.5g6.25xxxxxxx44替硝唑氯化钠注射液83注射剂200ml：0.8g13.86xxxxxxx45奥硝唑氯化钠注射液84注射剂100ml：0.5g30.15xxxxxxx注射用奥硝唑85今达注射剂0.25g19.73xxxxxxx奥硝唑分散片86固特分散片0.25g*2428.00xxxxxxx奥硝唑片87潇然片剂0.25g*1816.14xxxxxxx左奥硝唑氯化钠注射液88优诺安注射剂100ml:0.5g116.50xxxxxxx其它抗菌药物46利奈唑胺注射液89斯沃注射剂300ml:600mg393