Lampiran 4

Daftar Obat Antibiotik di RSUP Fatmawati Tahun 2017

No. Nama Obat Sediaan Harga (Rp) Pemakaian

1 AMOXICILLIN CAP 500 MG TABLET, KAPSUL 456 3.145
2 ABBOTIC XL TAB 500 MG TABLET, KAPSUL 40.649 186
3 AMOXSAN CAP 500 MG TABLET, KAPSUL 2624 385
4 AVELOX 400 MG TABLET, KAPSUL 30.500 81
AZITROMISIN TABLET 500
5 TABLET, KAPSUL 1.900 3639
MG
AMOXYCILLIN CAP 500
6 TABLET, KAPSUL 340 10.301
MG KF
AMOXYCILLIN TAB 500
7 TABLET, KAPSUL 190 2.000
MG
AMOXYCILLINE TAB 500
8 TABLET, KAPSUL 330 2.525
MG
BAQUINOR FORTE KAPL
9 TABLET, KAPSUL 10.949 965
500 MG
10 BACTESYN 375 MG TABLET, KAPSUL 16.500 1.709
11 CEFIXIME CAP 100 MG TABLET, KAPSUL 800 306.110
12 CEFSPAN 200 MG TABLET, KAPSUL 26.180 801
13 CEFAT KAPSUL 500 MG TABLET, KAPSUL 8.386 671
CLINDAMYCIN CAP 150
14 TABLET, KAPSUL 702 25.617
MG
CLINDAMYCIN CAP 300
15 TABLET, KAPSUL 1.397 23.543
MG
16 CRAVIT TAB 500 MG TABLET, KAPSUL 34.595 180
17 CEFADROXIL KAP 500 MG TABLET, KAPSUL 510 21.059
CEFADROXIL KAPSUL 500
18 TABLET, KAPSUL 450 1.300
MG
19 CEFIXIME 100 MG KAPS TABLET, KAPSUL 590 29.920
CIPROFLOXACIN 500 MG
20 TABLET, KAPSUL 240 9.036
TAB
21 CEFADROXIL CAPS 500 MG TABLET, KAPSUL 530 5.102
22 CEFADROXIL CAP 500 MG TABLET, KAPSUL 550 4.000
23 CEFSPAN CAPSUL 100 MG TABLET, KAPSUL 16.913 204
CHLORAMPHENICOL CAP
24 TABLET, KAPSUL 385 358
250 MG
25 CLANEKSI KAPL 625 MG TABLET, KAPSUL 4.400 24.569
26 CIPROFLOXACIN 500 MG TABLET, KAPSUL 281 28.255
DOXYCYCLINE CAP 100
27 TABLET, KAPSUL 327 1.996
MG
28 DOXICOR KAPSUL 100 MG TABLET, KAPSUL 5.610 840
DOXYCYCLINE TAB 100
29 TABLET, KAPSUL 268 186
MG
KLARITROMISIN CAPS 500
30 TABLET, KAPSUL 2.610 78
MG
LINCOMYCIN 500 MG KAP
31 TABLET, KAPSUL 1.458 855
PHP
LEVOFLOXACIN TAB 500
32 TABLET, KAPSUL 1.154 29.729
MG
33 MEIACT TAB 200 MG TABLET, KAPSUL 21.945 86
METRONIDAZOL TABLET
34 TABLET, KAPSUL 133 5.011
500 MG
OFLOXACIN TABLET 200
35 TABLET, KAPSUL 348 8.344
MG
 OFLOXACIN TABLET 400
36 TABLET, KAPSUL 553 10.669
MG
37 PROLIC KAPSUL 300 MG TABLET, KAPSUL 4.032 454
38 ZINNAT TABLET 500 MG TABLET, KAPSUL 6.000 35
CEFADROXIL SYRUP 250
39 SIRUP 5.940 98
MG/5 ML 60 ML
AMOXYCILLIN SYR 60 ML
40 SIRUP 2.090 192
(125 MG/5 ML)
AMOXSAN SYR 60 ML (125
41 SIRUP 17.997 5
MG/5 ML)
ABBOTIC SRY SYR 30 ML
42 SIRUP 91.476 22
(125 MG/5 ML)
AMOXICILLIN SYR
43 KERING 125 MG/5 ML, 60 SIRUP 1.881 124
ML
AMOKSISILIN SIRUP
44 KERING FORTE 250 SIRUP 3.519 29
MG/5ML
AMOKSISILIN SIRUP
45 SIRUP 4.222 40
KERING 125 MG/5ML
AZITROMISIN SIRUP 200
46 SIRUP 29.898 1
MG/5 ML
CEFSPAN DRY SYR 30 ML
47 SIRUP 75.900 15
(100 MG/5 ML)
CEFADROXIL SYR 60 ML
48 SIRUP 5.904 287
(125 MG/5 ML)
49 CLANEKSI DRY SYRUP SIRUP 32.987 250
CLANEKSI FORTE DRY
50 SIRUP 5.250 138
SYRUP
CEFIXIME SYR 30 ML (100
51 SIRUP 13.613 600
MG/5 ML)
CEFIXIME SYR 100 MG/5
52 SIRUP 6.150 159
ML, 30 ML
COMTRO SIR KERING 125
53 SIRUP 26.244 2
MG/5 ML
AMPICILIN SERBUK
INJEKSI I.M/I.V 1000
54 INFUS, INJEKSI 5.100 601
MG/VIAL (SBG GARAM
NA)
55 AVELOX IV 250 ML INFUS, INJEKSI 240.000 159
AMIKACIN INJ 250 MG 2
56 INFUS, INJEKSI 60.984 518
ML
AMIKACIN INJ 500 MG 2
57 INFUS, INJEKSI 29.700 5.330
ML
58 AMOXSAN INJ 1 G INFUS, INJEKSI 27.500 5
59 AMOXSAN 500 MG INJ INFUS, INJEKSI 28.000 3
60 ANBACIM VIAL 1 G INFUS, INJEKSI 31.262 889
61 BACTESYN INJ 1.5 G INFUS, INJEKSI 75.460 5.667
62 BACTESYN INJ 0,75 G INFUS, INJEKSI 80.410 60
63 SEFAZOLIN VIAL 1 G INFUS, INJEKSI 17.000 7.288
64 CEFTADIZIME INJ INFUS, INJEKSI 12.789 4.816
65 CEFTRIAXONE 1 G (IF) INFUS, INJEKSI 9.900 117.336
66 CIPROFLOXACIN INF INFUS, INJEKSI 11.489 4.415
67 CLANEKSI INJ INFUS, INJEKSI 62.062 16.112
68 CEFOTAXIM SERB INJ 1000 INFUS, INJEKSI 6.237
MG 4.847
 CEFOPERAZONE
69 INFUS, INJEKSI 38.610 840
SULBACTAM 1 GR
70 COLSANCETINE INJ 1 G INFUS, INJEKSI 13.129 1.469
71 CEFEPIME INJ 1 G INFUS, INJEKSI 36.000 792
72 CEFOPERAZONE 1 G INFUS, INJEKSI 38.500 10.267
CEFOPERAZONE
73 INFUS, INJEKSI 26.400 396
SULBACTAM 1 GR
74 CEFOTAXIME INJ 1000 MG INFUS, INJEKSI 9.009 1.000
75 CINAM INJ 1,5 G INFUS, INJEKSI 72.875 4.426
76 CEFOPERAZON INJ 1 G INFUS, INJEKSI 17.450 18.384
77 CAPSINAT INJEKSI INFUS, INJEKSI 24.882 6.792
DIBEKACINE INJ. 100 MG/2
78 INFUS, INJEKSI 75.688 377
ML
79 DIAZOLE INFUS 100 ML INFUS, INJEKSI 7.700 17.958
80 FOSMICIN 1 GR INFUS, INJEKSI 71.957 2.616
81 FOSMICIN 2 GR INFUS, INJEKSI 115.500 1.452
GENTAMYCIN INJ 40
82 INFUS, INJEKSI 3.083 13.655
MG/ML
LEVOFLOXACIN INFUS 5
83 INFUS, INJEKSI 27.999 3.971
MG/ML 100 ML
84 LEVOFLOXACIN INFUS INFUS, INJEKSI 22.318 2.102
LEVOFLOXACIN INFUS 5
85 INFUS, INJEKSI 27.007 14.833
MG/ML 100 ML (DEXA)
METRONIDAZOL INF 500
86 INFUS, INJEKSI 7.700 3.336
MG/100 ML
87 MEROPENEM INJ 1 GR INFUS, INJEKSI 44.490 22.327
88 MEROPENEM INJ 0.5 GR INFUS, INJEKSI 31.456 261
METRONIDAZOL INFUS 5
89 INFUS, INJEKSI 8.525 11.410
MG/ML
METRONIDAZOL INFUS 5
90 INFUS, INJEKSI 8.525 2.515
MG/ML 100 ML
91 MEROPENEM I GR INJ INFUS, INJEKSI 42.570 29
92 PEHAMOXIL VIAL 1 G INFUS, INJEKSI 16.672 195
93 PELASTIN VIAL 1 G INFUS, INJEKSI 165.034 1.724
PROCAIN
94 BENZILPENICILIN SERB INFUS, INJEKSI 11.147 116
INJ 3JUTA I.U
PROCAIN BENZIL
95 INFUS, INJEKSI 8.615 279
PENICILIN 3JT
96 SHAROX 750 MG INJ INFUS, INJEKSI 92.950 39
97 SEFEPIM SERB INJ 1000 MG INFUS, INJEKSI 28.797 608
SEFOTAKSIM SERB INJ
98 INFUS, INJEKSI 4.663 13.162
1000 MG
SIPROFLOXACIN INF
99 INFUS, INJEKSI 9.911 2.549
2MG/ML
100 TAZOCIN 4,5 GR INFUS, INJEKSI 326.264 28
101 TYGACIL VIAL 50 MG/5 ML INFUS, INJEKSI 662.725 633
102 VANCEP 0.5 G INJ INFUS, INJEKSI 122.000 741
103 VICCILLIN SX INJ 1,5 G INFUS, INJEKSI 35.000 17.992
104 AMOXSAN PAED DROPS 15
DROP 17.997 2
ML (250 MG/5 ML)
TOTAL 913.228