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）品种编号1普通青霉素类品规编号商用名称零售价格生产（元）企业0.39注射剂80 万 U0.63注射剂160 万 U20.56阿莫仙胶囊剂0.5g*2418.26xxxxxxxxxxxxxxxxxxxxx分级非 限 制 使 用限制使用级级(共 44 种)(共 39 种)√√√√特 殊 使 用 级(共 9 种)备注分类通用名剂型规格青霉素 G 钠1青霉素 G 钠22广谱青霉素阿莫西林胶囊3阿莫西林分散片4分散片0.5g*10xxxxxxx3注射用美洛西林钠4注射用阿洛西林钠5注射用磺苄西林钠6注射用氟氯西林钠注射用氟氯西林钠氟氯西林钠胶囊青霉素类复方制剂（β-内酰胺酶抑制剂）5678910111213力扬万普健颇佳伊芬君尔清注射剂2.0g注射剂1.5g注射剂1.0g注射剂1.5g注射剂1.0g注射剂2.0g注射剂0.5g注射剂1.0g胶囊剂0.25g*12注射剂0.6g注射剂1.2g28.0722.855.8939.8033.4151.2338.0098.7739.0011.57xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx√√√√√√√√√√√对酶稳定的青霉素类14注射用阿莫西林克拉维酸钾15714.92阿莫西林克拉维酸钾片注射用美洛西林/舒巴坦钠161718君尔清开林凯伦新泰林片剂注射剂注射剂注射剂注射剂注射剂注射剂注射剂胶囊剂片剂注射剂注射剂375mg*151.25g3.75g1.25g2.25g45.7432.8380.7669.0027.3045.680.8543.6516.00xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx√√√√√√√√√√√√89注射用哌拉西林 / 他 唑 巴 坦钠注射用氨苄西林/舒巴坦钠注射用头孢唑林注射用五水头孢唑林钠头孢羟氨苄胶囊头孢羟氨苄咀嚼片注射用头孢西酮192021222324252627102.25g0.5g1.0g0.25g*120.125g*160.5g1.0g11第一代头孢菌素类1279．37xxxxxxx143.00xxxxxxx230.00xxxxxxx1314注射用头孢硫脒2829仙力素仙力素明可欣安可欣库欣胜寒银力舒亿代罗氏芬罗氏芬注射剂注射剂注射剂注射剂片剂胶囊剂注射剂注射剂分散片胶囊剂注射剂注射剂0.5g1.0g0.75g1.5g0.125g*120.25g*60.25g1.0g0.25g*60.25g*60.5g1.0 g27.7946.8625.7444.6127.9013.7015.0335.6730.7620.5133.5657.13xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx√√√√√√√√√√√√注射用头孢呋辛钠15注射用头孢呋辛钠头孢呋辛酯分散片第二代头孢菌素类16头孢克洛胶囊注射用盐酸头孢替安注射用盐酸头孢替安头孢丙烯分散片头孢丙烯胶囊注射...
