Antibiotics - Therapeutic Classification


Generic Name(s)	Strength	Dosage Form	ICD Code
Daptomycin	500mg	Injection	Y40.9
Lincomycin	2ml/Vials, 10ml/Vials	Injection	Y40.8
Meropenem	125mg/Vial, 250mg/Vial, 500mg/Vial, 1000mg/Vial	Injection	Y40.9
Meropenem and Vaborbactam	2 g	Injection
Nitrofurazone	0.2%/1gm	Cream, Ointment, Powder	Y56
Penicillin v Potassium	250mg, 500mg	Tablet	Y40.0
Polymyxin, Bacitracin and Neomycin	3.5gm,	Eye Drops, Ointment	Y40.9
Procaine/ Penicillin	600,000 to 1,000,000 units/day	Injection	Y40.0
Rifaximin	200mg, 550mg, 400mg	Tablets
Roxithromycin	50mg, 150mg	Tablets	Y40
Sisomicin	3mg/3ml	Eye drops	Y40
Sodium fusidate			Y56.8
Spiramycin	0.375 MIU x 5 mL x 60ml	Suspension	Y40
Sultamicillin	250mg, 375mg	Tablets	Y40
Teicoplanin	200mg, 400mg/vial	Injection	Y40
Telavancin	250 or 750mg/vial	Injection	Y40
Telithromycin	400mg	Tabletss	Y40
Tyrothricin			Y40

aminoglycosides
Generic Name(s)	Strength	Dosage Form	ICD Code
Amikacin	100 mg per 2 mL, 500 mg per 2 mL, 1 gram per 4 mL	Injection	Y40.5
Capreomycin	1g/Vial	Injection	Y40.5
Framycetin	0.5%/ml, 1%/5gm, 0.5%/gm	Drop, Cream, Ointment	Y40.5
Gentamicin Ophthalmic	0.3%/5ml	Eye Drops	Y40.5
Kanamycin	500mg/Vial	Injection	Y40.5
Netilmicin	10mg/1ml, 25mg/1ml, 100mg/1ml	Injection	Y40.5
Spectinomycin	2-gram vial	Injection	Y40.5

antineoplastic antibiotic
Generic Name(s)	Strength	Dosage Form	ICD Code
Plicamycin	2500 mcg	Injection	Y43.3

Bacteriostatic Antibiotic
Generic Name(s)	Strength	Dosage Form	ICD Code
Fusidic acid	20mg/1gm, 2%/10gm	Cream, Ointment	Y56

Cephalosporins
Generic Name(s)	Strength	Dosage Form	ICD Code

Cefaclor	250mg, 500mg	Capsule	Y40.1
Cefaclor	125mg/5ml, 187mg/5ml, 250mg/5ml, 375mg/5ml	Suspension	Y40.1
Cefadroxil	500mg, 1g	Capsule,Tablet	Y40.1
Cefamandole	1g, 2g/Vial	Injection	Y40.1
Cefazolin	1g/50ml	Injection	Y40.1
Cefdinir	300mg	Capsule	Y40.1
Cefdinir	125mg/5ml	Suspension	Y40.1
Cefditoren	200 and 400mg.	Tablets	Y40.1
Cefepime	500mg, 1g, 2g/Vial	Injection	Y40.1
Cefetamet			Y40.1
Cefixime	100mg/5ml	Suspension	Y40.1
Cefoperazone Sodium Injection	10 g/Vial	Injection	Y40.1
Cefotaxime	500mg, 1g, 2g/Vial	Injection	Y40.1
Cefotetan	1g, 2g/Vial	Injection	Y40.1
Cefoxitin	1g, 2g, 10g/Vial	Injection	Y40.1
Cefpirome			Y40.1
Cefpodoxmine Proxetil	100g, 200g	Tablets, Oral Suspension	Y40.1
Cefprozil	250mg, 500mg	Tablet	Y40.1
Cefprozil	125mg/5ml, 250mg/5ml	Suspension	Y40.1
Ceftaroline Fosamil Injection	400g, 600g/Vial	Injection	Y40.1
Ceftazidime	1g, 2g, 10g/Vial	Injection	Y40.1
Ceftibuten	400mg	Capsules and Oral Suspension	Y40.1
Ceftizoxime	250mg, 1g	Injection
Ceftriaxone	500mg, 1g/Vial	Injection	Y40.1
Cefuroxime	125mg/5ml, 250mg/5ml	Suspension	Y40.1
Cefuroxime axetil	125mg, 250mg, 500mg	Tablet	Y40.1
Cephalexin	250mg, 500mg	Capsule, Tablet	Y40.1
Cephalexin	125mg/5ml, 250mg/5ml	Suspension	Y40.1
Cephaloridine	1g, 0.5g	Injection
Cephradine	250mg, 500mg	Capsule	Y40.1
Cephradine	125mg/5ml, 250mg/5ml	Suspension	Y40.1

Fluoroquinolones
Generic Name(s)	Strength	Dosage Form	ICD Code
Gatifloxacin	200-mg and 400-mg	Tablets , Injection,	Y40.8
Gemifloxacin	320mg	Tablet, Injection
Lomefloxacin	400mg	Tablet	Y40.8
Pefloxacin	400mg, 0.3%/5ml, 400mg/100ml, 100mg/50ml	Tablet, Drop, Injecion	Y40.8
Sparfloxacin	100mg, 200mg	Tablets	Y40.8

Glycylcycline Antibiotic- Anti-infective
Generic Name(s)	Strength	Dosage Form	ICD Code
Tigecycline	50mg/5ml	Injection	Y41

Macrolides
Generic Name(s)	Strength	Dosage Form	ICD Code
			Y40.3
Azithromycin	1000mg	Packet	Y40.3
Azithromycin	250mg, 600mg	Tablet	Y40.3
Azithromycin	100mg/5ml, 200mg/5ml	Suspension	Y40.3
Azithromycin	2g/60ml	Suspension	Y40.3
Clarithromycin	250mg, 500mg	Tablet	Y40.3
Clarithromycin	125mg/5ml, 250mg/5ml	Suspension	Y40.3
Clarithromycin	500mg	Tablet	Y40.3
Erythromycin	250mg, 333mg, 500mg	Capsule, Tablet	Y40.3
Erythromycin	40mg/ml, 200mg/5ml, 400mg/5ml	Drops, Suspension	Y40.3
Erythromycin Estolate	250mg	Capsule	Y40.3
Erythromycin Estolate	125mg/5ml, 250mg/5ml	Suspension	Y40.3
Erythromycin Ethylsuccinate	200mg, 400mg	Chewtab, Tablet	Y40.3
Erythromycin Ethylsuccinate/Sulfisoxazole	40mg/ml, 200mg/5ml,400mg/5ml	Suspension	Y40.3
Erythromycin Stearate	250mg, 500mg	Tablet	Y40.3
Fidaxomicin	200mg	Tablet	Y40.3
Troleandomycin	250mg	Capsules	Y40.3

Monocyclic Beta-lactam Antibiotic
Generic Name(s)	Strength	Dosage Form	ICD Code
Aztreonam	1 g/vial, 2 g/vial	Injection	Y40.1
Doripenem	500mg/1vial	Injection	Y40.1

penicillins
Generic Name(s)	Strength	Dosage Form	ICD Code
			Y40.0
	600mg-42.9mg/5ml		Y40.0
Amoxicillin	250mg, 500mg	Capsule	Y40.0
Amoxicillin	50mg/ml, 125mg/5ml, 200mg/5ml, 250mg/5ml, 400mg/5ml	Drops, Suspension	Y40.0
Amoxicillin	125mg, 200mg, 250mg, 400mg	Chewable Tablet	Y40.0
Amoxicillin and Clavulanate Potassium	250mg/125mg, 1000mg/62.5mg	Tablet	Y40.0
Amoxicillin and Clavulanate Potassium	500mg/125mg, 875mg/125mg	Tablet	Y40.0
Amoxicillin and Clavulanate Potassium	125mg/31.5mg, 25mg/62.5mg	Chewable Tablet	Y40.0
Amoxicillin and Clavulanate Potassium	200mg/28.3mg, 400mg/57mg	Chewable Tablet	Y40.0
Amoxicillin and Clavulanate Potassium	125mg/31.25mg/5ml, 250mg/62.5mg/5ml	Suspension	Y40.0
Amoxicillin and Clavulanate Potassium	200mg-28.5mg/5ml, 400mg-57mg/5ml,	Suspension	Y40.0
Amoxicillin and Clavulanic acid	125 mg/5 mL, 200 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL, 125-mg, 200-mg , 250-mg, 400-mg , 500-mg, 875-mg	Tablets, Oral Suspension	Y40.0
Ampicillin	250mg, 500mg	Capsule	Y40.0
Ampicillin	125mg/5ml, 250mg/5ml	Suspension	Y40.0
Ampicillin and Sulbactam	1.5 g, 3 g vials	Injection	Y40.0
Bacampicillin			Y40.0
Bacitracin (Neomycin/Polymyxin B) Ophthalmic	1/2 oz	Ointment	Y40.0
Cloxacillin	250mg, 500mg, 125mg/5ml	Capsule, Injection, Dry syrup
Dicloxacillin	250mg, 500mg	Capsule	Y40.0
Mezlocillin sodium			Y40.0
Oxacillin Injection	1gm/50ml, 2gm/50ml	Injection	Y40.0
Oxacillin Injection	1gm, 2gm	Injection	Y40.0
Penicillin VK	250mg, 500mg	Tablet	Y40.0
Penicillin VK	125mg/5ml, 250mg/5ml	Suspension	Y40.0
Piperacillin/Tazobactam	4000mg/500mg/Vial, 1000mg/125mg/Vial, 2000mg/250mg/Vial	Injection	Y40.0

Penicillins +Mucolytic agent
Generic Name(s)	Strength	Dosage Form	ICD Code
Amoxicillin and Bromhexine			Y40.0
Amoxicillin and Carbocisteine			Y40.0

quinolones
Generic Name(s)	Strength	Dosage Form	ICD Code
			Y41.8
Balofloxacin	100mg	Tablets	Y41.8
Ciprofloxacin	250mg/5ml, 500mg/5ml	Suspension	Y41.8
Ciprofloxacin	250mg, 500mg, 750mg	Tablet	Y41.8
Garenoxacin Mesylate			Y41.8
Levofloxacin	250mg, 500mg	Tablet	Y41.8
Nalidixic Acid	125mg, 300mg, 150mg, 300mg/5ml	Tablet, Suspension, Syrup	Y41.8

Sulfonamides
Generic Name(s)	Strength	Dosage Form	ICD Code
			Y41.0
Sulfadiazine	500mg	Tablet	Y41.0
Sulfisoxazole	500mg	Tablet	Y41.0
Sulfisoxazole	500mg/5ml	Suspension	Y41.0
Sulfisoxazole/Erythromycin Ethylsuccinate	600mg+200mg/5ml	Suspension	Y41.0
Sulfisoxazole/Phenazopyridine	500mg + 50mg	Tablet	Y41.0
Trimethoprim/Sulfamethoxazole	40mg+200mg/5ml	Suspension	Y41.0
Trimethoprim/Sulfamethoxazole	80mg/400mg	Tablet	Y41.0
Trimethoprim/Sulfamethoxazole DS	160mg/800mg	Tablet	Y41.0

Tetracyclines
Generic Name(s)	Strength	Dosage Form	ICD Code
Demeclocycline	150mg, 300mg	Tablet	Y40.4
Doxycycline	50mg, 100mg	Capsule, Tablet,	Y40.4
Doxycycline	25mg/5ml, 50mg/5ml	Suspension, Syrup	Y40.4
Minocycline	50mg, 75mg, 100mg	Capsule	Y40.4
Omadacycline	100 mg, 150 mg	Injection, Tablet
Oxytetracycline	250mg, 500mg, 50mg/1ml, 10mg/1gm, 30mg/1gm	Capsule, Injection, Ointment	Y40.4
Tetracycline	250mg, 500mg	Capsule, Tablet	Y40.4
Tetracycline	125mg/5ml	Suspension	Y40.4