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HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA FORMULARY ANTIBIOTIC COSTS
JULY 2005 PRICING
| ANTIMICROBIAL AGENT (trade name) | UNIT | HUP COST | USUAL DOSE | HUP ACQUISITION COST/DAY |
| AMINOGLYCOSIDES | ||||
| Amikacin (Amikin) | 500 mg IV | $3.15 | 1 gm q24h (70kg, normal renal function) | $6.30 |
| Gentamicin (Garamycin) | 80 mg IV | $0.50 | 350 mg q24h (70kg, normal renal function) | $2.19 |
| Tobramycin (Nebcin) | 80 mg IV | $1.26 | 350 mg q24h (70kg, normal renal function) | $5.51 |
| CEPHALOSPORINS | ||||
| Cefadroxil (Duricef) | 500 mg PO | $0.59 | 500 mg q12h | $1.18 |
| Cefazolin (Ancef, Kefzol) | 500 mg IV | $0.46 | 500 mg q8h | $1.38 |
| 1 gm IV | $0.92 | 1 gm q8h | $2.76 | |
| Cefepime (Maxipime) | 1gm IV | $11.94 | 1 gm q12h | $23.88 |
| 2gm IV | $23.70 | 2 gm q12h | $47.40 | |
| 1gm q8h | $35.82 | |||
| Ceftriaxone (Rocephin) | 1 gm IV | $12.00 | 1 gm q24h | $12.00 |
| 2 gm IV | $24.00 | 2 gm q12h | $48.00 | |
| Cefuroxime Axetil (Ceftin) | 250 mg PO | $0.39 | 250 mg q12h | $0.78 |
| 500 mg PO | $0.78 | 500 mg q12h | $1.56 | |
| Cephelexin (Keflex) | 250 mg PO | $0.09 | 250mg q6h | $0.36 |
| 500 mg PO | $0.15 | 500mg q6h | $0.60 | |
| PENICILLINS | ||||
| Amoxicillin (Polymox, Wymox) | 500 mg PO | $0.10 | 500mg q12h | $0.20 |
| 875 mg PO | $0.39 | 875mg q12h | $0.78 | |
| 1 gm PO | $0.20 | 1 gm q8h | $0.60 | |
| Amoxicillin/clavulanic acid (Augmentin) | 500 mg PO | $1.38 | 500 mg q12h | $6.26 |
| 875 mg PO | $2.30 | 875 mg q12h | $8.34 | |
| 250mg/5ml SUSP | $0.45 | 500 mg q12h | $1.80 | |
| 400mg/5ml SUSP | $1.25 | 800 mg q12h | $5.00 | |
| Ampicillin (Polycillin, Omnipen) | 1 gm IV | $4.57 | 1 gm q4-6h | $18.28-27.42 |
| 2 gm IV | $7.92 | 2 gm q4-6h | $31.68-47.52 | |
| 500 mg PO | $0.12 | 500 mg q6h | $0.48 | |
| Ampicillin/sulbactam (Unasyn) | 1.5 gm IV | $5.47 | 1.5 gm q6h | $21.88 |
| 3 gm IV | $10.94 | 3 gm q6h | $43.76 | |
| Dicloxacillin (Dynapen) | 250 mg PO | $0.23 | 500 mg q6h | $0.92 |
| Nafcillin (Unipen) | 1 gm IV | $5.56 | 1 gm q4h | $33.36 |
| 2 gm IV | $11.12 | 2 gm q4h | $66.72 | |
| Penicillin G (various) | 1,000,000 u IV | $6.86 | 3 mu q4h | $123.48 |
| Penicillin V K | 500 mg PO | $0.15 | 500 mg q6h | $0.60 |
| Piperacillin | 3 gm IV | $9.31 | 3 gm q4h | $55.86 |
| 4 gm IV | $12.41 | 4 gm q6h | $49.64 | |
| Piperacillin/tazobactam | 3.375 gm IV | $13.90 | 3.375 gm q4h | $83.40 |
| 4.5 gm IV | $18.53 | 4.5 gm q6-8h | $55.59-74.12 | |
HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA FORMULARY ANTIBIOTIC COSTS
| ANTIMICROBIAL AGENT (trade name) | UNIT | HUP COST | USUAL DOSE | HUP ACQUISITION COST/DAY |
| MACROLIDES | ||||
| Azithromycin (Zithromax) | 500 mg IV | $22.93 | 500 mg q day | $22.93 |
| 250 mg PO | $6.46 | 250-500 mg q day | $6.46-$12.92 | |
| 1 gm packet | $20.07 | 1 gm x 1 | $20.07 | |
| 600 mg | $15.51 | 600 mg q day | $15.51 | |
| Clarithromycin (Biaxin) | 250 mg PO | $4.16 | 250 mg q12h | $8.32 |
| 500 mg PO | $4.16 | 500 mg q12h | $8.32 | |
| Erythromycin (Erythrocin) | 500 mg IV | $3.06 | 500mg q6h | $12.24 |
| 500 mg PO | $0.15 | 500mg q6h | $0.60 | |
| MISCELLANEOUS ANTIBIOTICS | ||||
| Aztreonam (Azactam) | 1 gm IV | $18.85 | 1 gm q8h | $56.55 |
| 2 gm IV | $37.64 | 2 gm q8h | $112.92 | |
| Chloramphenicol (Chloromycetin) | 1 gm IV | $6.20 | 1 gm q6h | $24.80 |
| Clindamycin (Cleocin) | 600 mg IV | $8.68 | 600 mg q8h | $26.04 |
| 900 mg IV | $10.60 | 900 mg q8h | $31.80 | |
| 150 mg PO | $0.44 | 300 mg q6h | $3.52 | |
| 450 mg q6h | $5.28 | |||
| Colistimethate (Coly-Mycin-M) | 150 mg IV | $16.31 | 150 mg q12h | $32.62 |
| Doxycycline (Vibramycin) | 100 mg PO | $0.08 | 100 mg q12h | $0.16 |
| 100 mg IV | $3.66 | 100 mg q12h | $7.32 | |
| Levofloxacin (Levaquin) | 250 mg IV | $7.06 | 250 mg q24h | $7.06 |
| 500 mg IV | $14.12 | 500 mg q24h | $14.12 | |
| 750 mg IV | $15.70 | 750 mg q24h | $15.70 | |
| 250 mg PO | $2.40 | 250 mg q24h | $2.40 | |
| 500 mg PO | $2.40 | 500 mg q24h | $2.40 | |
| 750 mg PO | $4.80 | 750 mg q24h | $4.80 | |
| Linezolid (Zyvox) | 600 mg PO | $50.53 | 600 mg q12h | $101.06 |
| 600 mg IV | $67.03 | 600 mg q12h | $134.06 | |
| Meropenem | 1 gm IV | $29.89 | 1 gm q8h | $89.67 |
| Metronidazole (Flagyl) | 500 mg IV | $1.45 | 500 mg q12h | $2.90 |
| 500 mg PO | $0.08 | 500 mg q12h | $0.16 | |
| Nitazoxanide (Alinia) | 500 mg PO | $10.47 | 500 mg q12h x 3 days | $20.94 |
| Nitrofurantoin (Macrodantin, Macrobid) | 100 mg (IR) PO | $0.73 | 100 mg q6h | $2.92 |
| 100 mg (SR) PO | $0.87 | 100mg q12h | $1.74 | |
| 25mg/5ml (SUSP) PO | $0.68 | 100 mg q6h | $2.72 | |
| Norfloxacin (Noroxin) | 400 mg PO | $3.00 | 400 mg q12h | $6.00 |
| Quinupristin/dalfopristin (Synercid) | 500 mg IV | $93.67 | 525 mg q8h | $295.06 |
| Tetracycline (various) | 250 mg PO | $0.04 | 250 mg q6h | $0.16 |
| 500 mg PO | $0.06 | 500 mg q6h | $0.24 | |
| Trimethoprim/sulfamethoxazole
(TMP/SMX)
(Bactrim, Septra) |
80/400 mg IV | $2.26 | 2 amps q6h | $18.08 |
| 160/800 mg PO (double strength) | $0.14 | 1 DS q12h | $0.28 | |
| Vancomycin (Vancoled) | 1 gram IV | $4.19 | 1 gm q12h | $8.38 |
| 125 mg PO | $9.60 | 125mg q6h | $38.40 | |
HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA FORMULARY ANTIBIOTIC COSTS
| ANTIMICROBIAL AGENT (trade name) | UNIT | HUP COST | USUAL DOSE | HUP ACQUISITION COST/DAY |
| ANTI-VIRAL AGENTS | ||||
| Abacavir (Ziagen) | 300 mg PO | $5.24 | 300 mg q12h | $10.48 |
| Abacavir/lamivudine (Epzicom) | 600 mg/ 300 mg PO | $21.27 | 1 tablet q day | $21.27 |
| Abacavir/lamivudine/zidovudine (Trizivir) | 300mg/150mg/300mg PO | $15.94 | 1 tablet q12h | $31.88 |
| Acyclovir (Zovirax) | 200 mg PO | $0.07 | 200 mg 5x/day | $0.35 |
| 400 mg PO | $0.09 | 400 mg q8h | $0.27 | |
| 800 mg PO | $0.17 | 800 mg 5x/day | $0.85 | |
| 500 mg IV | $2.45 | 350 mg q8h | $5.15 | |
| Amprenavir (Agenerase) | 150 mg PO | $1.26 | 1200 mg q12h | $20.16 |
| Cidofovir (Vistide) | 375 mg IV | $725.64 | 350 mg q 2wks | $725.64 |
| Dideoxycytidine (ddi, Videx) | 250 mg (EC CAP) PO | $4.17 | 250 mg q day | $4.17 |
| 400 mg (EC CAP) PO | $6.51 | 400 mg q day | $6.51 | |
| Efavirenz (Sustiva) | 600 mg PO | $13.06 | 600 mg q day | $13.06 |
| Emtricitabine/tenofovir (Truvada) | 200 mg/300 mg PO | $22.70 | 1 tablet q day | $22.70 |
| Fosamprenavir (Lexiva) | 700 mg PO | $8.62 | 1400 mg q day | $17.24 |
| Foscarnet (Foscavir) | 6 gm IV | $61.60 | 4.2 gm q8h | $129.36 |
| Ganciclovir (Cytovene) | 500 mg IV | $30.01 | 350 mg q12h | $42.01 |
| 250 mg PO | $2.36 | 1000 mg q8h | $28.32 | |
| Indinavir (Crixivan) | 400 mg PO | $2.49 | 800 mg q8h | $14.94 |
| Lamivudine (3TC, Epivir) | 150 mg PO | $4.54 | 150 mg q12h | $9.08 |
| Lamivudine + zidovudine (Combivir) | lamivudine 150mg + zidovudine 300mg | $9.84 | 1 tablet q12h | $19.68 |
| Lopinavir/ritonavir (Kaletra) | 133mg/33mg PO | $3.22 | 3 capsules q12h | $19.32 |
| Nelfinavir (Viracept) | 625 mg PO | $4.95 | 1250 mg q12h | $19.80 |
| Nevirapine (Viramune) | 200 mg PO | $5.78 | 200 mg q12h | $11.56 |
| Oseltamivir (Tamiflu) | 75 mg PO | $6.01 | 75 mg q12h | $12.02 |
| Ritonavir (Norvir) | 100 mg PO | $8.41 | 200 mg q day | $16.82 |
| Saquinavir (Invirase) | 500 mg PO | $4.89 | 1 gm q12h | $19.56 |
| Stavudine (d4T, Zerit) | 30 mg PO | $4.95 | 30 mg q12h | $9.90 |
| 40 mg PO | $5.05 | 40 mg q12h | $10.01 | |
| Tenofovir (Viread) | 300 mg PO | $13.62 | 300 mg q24h | $13.62 |
| Valacyclovir (Valtrex) | 500 mg PO | $3.65 | 500 mg q12h | $7.30 |
| Valganciclovir (Valcyte) | 450 mg PO | $23.28 | 900 mg q day | $46.56 |
| Zalcitabine (ddc, HIVID) | 0.375 mg PO | $1.78 | 0.375 mg q12h | $3.56 |
| 0.75 mg PO | $2.23 | 0.75 mg q12h | $4.46 | |
| Zidovudine (AZT, Retrovir) | 300 mg PO | $5.30 | 300 mg q12h | $10.60 |
| ANTI-FUNGAL AGENTS | ||||
| Amphotericin (Fungizone) | 50 mg IV | $7.84 | 35 mg q24h | $5.49 |
| Lipid Amphotericin B (Abelcet) | 100 mg IV | $73.55 | 210 mg q24h | $154.46 |
| Caspofungin (Cancidas) | 70 mg IV | $403.72 | 70 mg x 1 | $403.72 |
| 50 mg IV | $313.39 | 50 mg q day | $313.39 | |
| Clotrimazole troches (Mycelex) | 10 mg PO | $1.59 | 5x/day | $7.95 |
| Fluconazole (Diflucan) | 50 mg PO | $0.18 | 50 mg q day | $0.18 |
| 100 mg PO | $0.20 | 100 mg q day | $0.20 | |
| 150 mg PO | $0.25 | 150 mg x 1 | $0.25 | |
| 200 mg PO | $0.37 | 400 mg q day | $0.37 | |
| 200 mg IV | $14.71 | 200 mg q day | $14.71 | |
| 400 mg IV | $21.57 | 400 mg q day | $21.57 | |
| 800 mg IV | $43.14 | 800 mg q day | $43.14 | |
| Itraconazole (Sporanox) | 100 mg PO | $7.93 | 100-200 mg q12h | $15.86-31.72 |
| 10 mg/ml PO | $7.69 (100 mg) | 200 mg q12h | $30.76 | |
| 200 mg IV | $172.64 | 200 mg q24h | $172.64 | |
| Micafungin (Mycamine) | 50 mg IV | $91.20 | 50 mg q day | $91.20 |
| Voriconazole (Vfend) | 200 mg IV | $85.85 | 280 mg q12h | $240.38 |
| 200 mg PO | $27.52 | 200 mg q12h | $55.04 | |
HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA FORMULARY ANTIBIOTIC COSTS
| ANTIMICROBIAL AGENT (trade name) | UNIT |
HUP COST |
USUAL DOSE | HUP ACQUISITION COST/DAY |
| ANTI-TUBERCULOSIS AGENTS | ||||
| Ethambutol (myambutol) | 100 mg PO | $0.37 | 15-25 mg/kg/d (70 kg = 1 gm/d) | $2.74 |
| 400 mg PO | $1.00 | |||
| Isoniazid (various) | 100 mg PO | $0.08 | 300 mg q day | $0.24 |
| Pyrazinamide (Pyrazinamide) | 500 mg PO | $0.73 | 15-25 mg/kg/d (70kg=500 mg tid) | $2.19 |
| Rifampin (Rifadin) | 300 mg PO | $1.32 | 600 mg q day | $2.64 |
| 600 mg IV | $40.14 | 600 mg q day | $40.14 | |
| OPPORTUNISTIC INFECTIONS (HIV) | ||||
| Atovaquone (Mepron) | 750 mg oral suspension | $14.43 | 750 mg bid | $28.86 |
| Azithromycin (Zithromax) | 600 mg PO |
$15.51 |
1200 mg q week | $31.02/week |
| Clarithromycin (Biaxin) | 500 mg PO | $4.16 | 500 mg q12h | $8.32 |
| Dapsone (Dapsone) | 100 mg PO | $0.16 | 100 mg q day | $0.16 |
| Pentamidine (Nebupent) | 300 mg IH | $31.38 | 300 mg INH q month | $31.38/month |
| 300 mg IV | $31.38 | 210 mg q24h | $21.97 | |
| Primaquine (Primaquine) | 26.3 mg PO (15mg base) | $0.85 | 15 mg base q day | $0.85 |
| Pyrimethamine (Daraprim) | 25 mg PO | $0.47 | 75 mg q day | $1.41 |
| Rifabutin (Mycobutin) | 150 mg PO | $5.87 | 300 mg q day | $11.74 |
| Sulfadiazine (Microsulfon) | 500 mg PO | $1.01 | 500 mg q6h | $4.04 |
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