University of Pennsylvania Medical Center Guidelines for Antimicrobial Therapy

JUNE 2008 PRICING

HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA FORMULARY ANTIBIOTIC COSTS

ANTIMICROBIAL AGENT (trade name) UNIT HUP COST USUAL DOSE HUP ACQUISITION COST/DAY
AMINOGLYCOSIDES
Amikacin (Amikin) 500 mg IV $2.51 1 gm q24h (70kg, normal renal function) $5.02
Gentamicin (Garamycin) 80 mg IV $0.79 350 mg q24h (70kg, normal renal function) $3.16
Streptomycin 1 gm IV $6.51 500 mg q12h (70kg, normal renal function) $6.51
Tobramycin (Nebcin) 80 mg IV $1.24 350 mg q24h (70kg, normal renal function) $6.20
CEPHALOSPORINS
Cefadroxil (Duricef) 500 mg PO $0.49 500 mg q12h $0.98
1 gm q12h $1.96
Cefazolin (Ancef, Kefzol) 500 mg IV $0.41 500 mg q8h $1.23
1 gm IV $0.83 1 gm q8h $2.49
Cefepime (Maxipime) 1 gm IV $5.78 1 gm q12h $11.56
1 gm q8h $17.34
2 gm IV $11.56 2 gm q12h $23.12
Ceftriaxone (Rocephin) 1 gm IV $3.57 1 gm q24h $3.57
2 gm IV $6.44 2 gm q12h $12.88
Cefuroxime Axetil (Ceftin) 250 mg PO $0.51 250 mg q12h $1.02
500 mg PO $1.02 500 mg q12h $2.04
Cephelexin (Keflex) 250 mg PO $0.07 250mg q6h $0.28
500 mg PO $0.08 500mg q6h $0.32
PENICILLINS
Amoxicillin (Polymox, Wymox) 500 mg PO $0.08 500 mg q12h $0.16
1 g q8h $0.48
875 mg PO $0.51 875 mg q12h $1.02
Amoxicillin/clavulanic acid (Augmentin) 500 mg PO $0.95 500 mg q12h $1.90
875 mg PO $2.03 875 mg q12h $4.06
250 mg/5 ml SUSP $3.28 500 mg q12h $13.12
400 mg/5 ml SUSP $0.83 800 mg q12h $3.32
Ampicillin (Polycillin, Omnipen) 1 gm IV $3.73 1 gm q6h $14.92
2 gm IV $5.86 2 gm q4 $35.16
Ampicillin/sulbactam (Unasyn) 1.5 gm IV $3.66 1.5 gm q6h $14.64
3 gm IV $6.91 3 gm q6h $27.64
Dicloxacillin (Dynapen) 250 mg PO $0.18 500 mg q6h $1.44
Nafcillin (Unipen) 2 gm IV $13.81 2 gm q4h $82.86
Penicillin G (various) 3,000,000 units IV $10.97 3,000,000 units q4h $65.82
2,000,000 units IV $10.56 4,000,000 units q4h $126.72
Penicillin V K 500 mg PO $0.15 500 mg q6h $0.60
Piperacillin 3 gm IV $9.67 3 gm q4h $58.02
4 gm IV $12.90 4 gm q6h $51.60
Piperacillin/tazobactam 3.375 gm IV $15.14 3.375 gm q4h $90.84
4.5 gm IV $19.18 4.5 gm q8h $57.54
4.5 gm q6h $76.72
MACROLIDES
Azithromycin (Zithromax) 500 mg IV $7.26 500 mg daily $7.26
250 mg PO $2.96 500 mg daily $5.92
1 gm packet PO $12.49 1 gm OTO $12.49
600 mg PO $4.08 1200 mg weekly $8.16
Clarithromycin (Biaxin) 250 mg PO $0.90 250 mg q12h $1.80
500 mg PO $0.51 500 mg q12h $1.02
Erythromycin (Erythrocin) 500 mg IV $10.06 500 mg q6h $40.24
500 mg PO $0.17 500 mg q6h $0.68
MISCELLANEOUS ANTIBIOTICS
Aztreonam (Azactam) 1 gm IV $28.01 1 gm q8h $84.03
2 gm IV $55.91 2 gm q8h $167.73
Chloramphenicol (Chloromycetin) 1 gm IV $14.28 900 mg q6h (70kg, normal renal function) $57.12
Clindamycin (Cleocin) 600 mg IV $10.04 600 mg q8h $30.12
900 mg IV $12.26 900 mg q8h

$36.78
150 mg PO $0.43 300 mg q6h $3.44
450 mg q6h $5.16
Colistimethate (Coly-Mycin-M) 150 mg IV $16.31 125 mg q8h (70kg, normal renal function) $48.93
Daptomycin (Cubicin) 500 mg IV $181.77 420 mg q24h (70kg, normal renal function) $181.77
Doxycycline (Vibramycin) 100 mg PO $0.08 100 mg q12h $0.16
100 mg IV $3.54 100 mg q12h $7.08
Fosfomycin tromethamine (Monurol) 3 gm PO $35.94 3 gm OTO $35.94
Levofloxacin (Levaquin) 250 mg IV $6.45 250 mg q24h $6.45
500 mg IV $12.90 500 mg q24h $12.90
750 mg IV $12.10 750 mg q24h $12.10
250 mg PO $2.38 250 mg q24h $2.38
500 mg PO $2.38 500 mg q24h $2.38
750 mg PO $4.76 750 mg q24h $4.76
Linezolid (Zyvox) 600 mg PO $63.70 600 mg q12h $127.40
600 mg IV $81.62 600 mg q12h $163.24
Meropenem 1 gm IV $29.22 1 gm q8h $87.66
Metronidazole (Flagyl) 500 mg IV $1.43 500 mg q12h $2.86
500 mg PO $0.05 500 mg q12h $0.10
2 gm OTO $0.20
Nitrofurantoin (Macrodantin, Macrobid) 100 mg (IR) PO $0.33 100 mg q6h $1.32
100 mg (SR) PO $0.69 100mg q12h $1.38
25mg/5ml (SUSP) PO $1.00 100 mg q6h $4.00
Norfloxacin (Noroxin) 400 mg PO $3.15 400 mg q12h $6.30
Tetracycline (various) 250 mg PO $0.03 250 mg q6h $0.12
500 mg PO $0.04 500 mg q6h $0.16
Tigecycline (Tygacil) 50 mg IV $52.50 50 mg q12h $105.00
Trimethoprim/sulfamethoxazole (TMP/SMX)

(Bactrim, Septra)

160/800 mg IV $2.93 160/800 mg q6h $11.72
160/800 mg PO (double strength) $0.14 1 DS q12h $0.28
Vancomycin (Vancoled) 1 gram IV $5.19 1 gm q12h $10.38
125 mg PO $0.65 125 mg q6h $2.60

HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA FORMULARY ANTIBIOTIC COSTS

ANTIMICROBIAL AGENT (trade name) UNIT HUP COST USUAL DOSE HUP ACQUISITION COST/DAY
ANTI-FUNGAL AGENTS
Amphotericin (Fungizone) 50 mg IV $11.66 70 mg q24h (1 mg/kg, 70kg) $23.32
Lipid Amphotericin B (Ambisome) 50 mg IV $50.99 210 mg q24h (3 mg/kg, 70kg) $254.95
350 mg q24h (5 mg/kg, 70kg) $356.93
Caspofungin (Cancidas) 50 mg IV $108.23 50 mg q day $108.23
Clotrimazole troches (Mycelex) 10 mg PO $0.83 10 mg 5x/day $4.15
Fluconazole (Diflucan) 100 mg PO $0.13 100 mg daily $0.13
200 mg PO $0.17 200 mg daily $0.17
400 mg daily $0.34
200 mg IV $7.58 200 mg daily $7.58
400 mg IV $11.39 400 mg daily $11.39
800 mg daily $22.78
Itraconazole (Sporanox) 100 mg PO $6.45 200 mg q12h $25.80
200 mg q24h $12.90
10 mg/ml PO $12.91 (100 mg) 200 mg q12h $51.64
200 mg q24h $25.82
Posaconazole (Noxafil) 40 mg/mL $4.21 200 mg q8h $63.16
Voriconazole (Vfend) 200 mg IV $98.44 280 mg q12h (70kg, normal renal function) $295.32
200 mg PO $33.45 200 mg q12h $66.90

HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA FORMULARY ANTIBIOTIC COSTS

ANTIMICROBIAL AGENT (trade name) UNIT HUP COST USUAL DOSE HUP ACQUISITION COST/DAY
ANTIRETROVIRAL AGENTS
Abacavir (Ziagen) 300 mg PO $7.01 600 mg daily $14.02
Abacavir/lamivudine (Epzicom) 600 mg/ 300 mg PO $24.47 1 tablet daily $24.47
Abacavir/lamivudine/zidovudine (Trizivir) 300 mg/150 mg/300 mg PO $18.33 1 tablet q12h $36.66
Atazanavir (Reyataz) 150 mg PO $13.31 300 mg daily $26.62
200 mg PO $13.32 400 mg daily $26.64
300 mg PO $26.64 300 mg daily $26.64
Darunavir (Prezista) 300 mg PO $6.65 600 mg q12h $26.60
Didanosine (ddi, Videx) 250 mg (EC CAP) PO $4.58 250 mg daily $4.58
400 mg (EC CAP) PO $7.15 400 mg daily $7.15
Efavirenz (Sustiva) 600 mg PO $4.78 600 mg daily $4.78
Efavirenz/emtricitabine/tenofovir (Atripla) 600 mg/200 mg/300 mg PO $42.82 1 tablet daily $42.82
Emtricitabine (Emtriva) 200 mg PO $9.95 200 mg daily $9.95
Emtricitabine/tenofovir (Truvada) 200 mg/300 mg PO $27.20 1 tablet daily $27.20
Enfuvirtide (Fuzeon) 90 mg IV $31.48 90 mg subq q12h $62.96
Etravirine (Intelence) 100 mg PO $5.29 200 mg q12h $21.16
Fosamprenavir (Lexiva) 700 mg PO $9.91 1400 mg daily $19.82
Indinavir (Crixivan) 400 mg PO $2.46 800 mg q8h $14.76
Lamivudine (3TC, Epivir) 300 mg PO $10.44 300 mg daily $20.88
Lamivudine/zidovudine (Combivir) 150 mg/300 mg PO $11.32 1 tablet q12h $22.64
Lopinavir/ritonavir (Kaletra) 200 mg/50 mg PO $5.68 2 tablets q12h $22.72
Maraviroc (Selzentry) 150 mg PO $14.08 150 mg q12h $28.16
300 mg PO $14.08 300 mg q12h $28.16
600 mg q12h $56.32
Nelfinavir (Viracept) 625 mg PO $5.10 1250 mg q12h $20.40
Nevirapine (Viramune) 200 mg PO $6.54 200 mg q12h $13.08
Raltegravir (Isentress) 400 mg PO $12.78 400 mg q12h $25.56
Ritonavir (Norvir) 100 mg PO $8.33 200 mg daily $16.66
Saquinavir (Invirase) 500 mg PO $5.87 1 gm q12h $23.48
Stavudine (d4T, Zerit) 30 mg PO $5.81 30 mg q12h $11.62
40 mg PO $5.92 40 mg q12h $11.84
Tenofovir (Viread) 300 mg PO $17.88 300 mg q24h $17.88
Zidovudine (AZT, Retrovir) 300 mg PO $0.45 300 mg q12h $0.90

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
Acyclovir (Zovirax) 400 mg PO $0.09 400 mg q8h $0.27
400 mg 5x/day $0.45
800 mg PO $0.12 800 mg q8h $0.36
800 mg 5x/day $0.60
500 mg IV $2.64 350 mg  q8h (70kg, normal renal function) $7.92
Adefovir (Hepsera) 10 mg PO $19.49 10 mg daily $19.49
Cidofovir (Vistide) 375 mg IV $718.69 350 mg q2wks (70kg, normal renal function) $718.69
Entecavir (Baraclude) 0.5 mg PO $22.07 0.5 mg daily $22.07
1 mg PO $22.07 1 mg daily $22.07
Foscarnet (Foscavir) 6 gm IV $54.81 4.2 gm q8h (70kg, normal renal function) $164.43
6.3 gm q12h (70kg, normal renal function) $164.43
Ganciclovir (Cytovene) 500 mg IV $33.71 350 mg q12h (70kg, normal renal function) $67.42
250 mg PO $2.46 1000 mg  q8h $29.50
Oseltamivir (Tamiflu) 75 mg PO $7.18 75 mg q12h $14.36
Telbivudine (Tyzeka) 600 mg PO $18.22 600 mg daily $18.22
Valacyclovir (Valtrex) 500 mg PO $5.24 500 mg q12h $10.48
1000 mg PO $9.14 1000 mg q8h $27.42
Valganciclovir (Valcyte) 450 mg PO $24.90 900 mg q day $49.80

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 $0.52 15-25 mg/kg/d (70 kg = 1200 mg daily) $2.76
400 mg PO $0.92
Isoniazid (various) 100 mg PO $0.04 300 mg daily $0.12
Pyrazinamide (Pyrazinamide) 500 mg PO $0.56 15-25 mg/kg/d (70kg = 1500 daily) $1.68
Rifampin (Rifadin) 300 mg PO $1.12 600 mg daily $2.24
600 mg IV $44.09 600 mg daily $44.09
Rifabutin (Mycobutin) 150 mg PO $8.61 300 mg daily $17.22
OPPORTUNISTIC INFECTIONS (HIV)
Atovaquone (Mepron) 750 mg oral suspension $16.60 750 mg twice daily $33.20
1500 mg daily
Dapsone (Dapsone) 100 mg PO $0.17 100 mg daily $0.17
Pentamidine (Nebupent) 300 mg INH $42.83 300 mg monthly $42.83
300 mg IV $42.83 280 mg q24h (70kg, normal renal function) $42.83
Primaquine (Primaquine) 26.3 mg PO (15mg base) $1.04 15 mg base daily $1.04
Pyrimethamine (Daraprim) 25 mg PO $0.47 75 mg daily $1.41
Sulfadiazine (Microsulfon) 500 mg PO $1.58 1500 mg q6h $18.96

HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA FORMULARY ANTIBIOTIC COSTS

ANTIMICROBIAL AGENT (trade name) UNIT HUP COST USUAL DOSE HUP ACQUISITION COST/DAY
ANTIPARASITICS
Mefloquine (Larium) 250 mg PO $4.52 250 mg weekly $4.52
1250 mg OTO $22.60
Nitazoxanide (Alinia) 500 mg PO $15.04 500 mg q12h x 3 days $30.08

 

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