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Appendix C Tables

Note: The medication tables are not meant to be inclusive lists of all available therapeutic agents. Approved medication tables will be updated regularly. Discrepancies must be reported. See Resource Section of this manual for additional contact information. Release Notes: Table Version 1.0 Table 1.1 Aspirin and Aspirin-Containing Acetylsalicylic Acid Acuprin 81 Alka-Seltzer Alka-Seltzer Morning Relief Anacin Arthritis Foundation Aspirin Arthritis Pain Ascriptin Arthritis Pain Formula ASA ASA Baby ASA Baby Chewable ASA Baby Coated ASA Bayer ASA Bayer Children's ASA Buffered ASA Children's ASA EC ASA Enteric Coated ASA/Maalox Ascriptin Aspergum Aspir-10 Aspir-Low Aspir-Lox Aspir-Mox Aspir-Trin Aspirbuf Aspircaf Aspirin Aspirin Baby Aspirin Bayer Aspirin Bayer Children's Aspirin Buffered Aspirin Child Aspirin Child Chewable Aspirin Children's Aspirin EC Aspirin Enteric Coated

Specifications Manual for National Appendix C-1 Hospital Quality Measures

Table 1.1 Aspirin and Aspirin-Containing Medications (continued) Aspirin Litecoat Aspirin Lo-Dose Aspirin Low Strength Aspirin Tri-Buffered Aspirin, Extended Release Aspirin/butalbital/caffeine Aspirin/caffeine Aspirin/pravachol Aspirin/pravastatin Aspirtab Bayer Aspirin Bayer Aspirin PM Extra Strength Bayer Children’s Bayer EC Bayer Enteric Coated Bayer Low Strength Bayer Plus Buffered ASA Buffered Aspirin Buffered Baby ASA Bufferin Bufferin Arthritis Strength Bufferin Extra Strength Buffex Cama Arthritis Reliever Child’s Aspirin Coated Aspirin Cosprin CTD Aspirin Dasprin Doans Pills Easprin EC ASA Ecotrin Ecotrin Low Strength Adult Effervescent Pain & Empirin Encaprin Entab Entaprin Entercote Enteric Coated Aspirin Enteric Coated Baby Aspirin Excedrin

Specifications Manual for National Appendix C-2 Hospital Quality Measures

Table 1.1 Aspirin and Aspirin-Containing Medications (continued) Excedrin Extra Strength Excedrin Geltab Excedrin Migraine Extra Strength Bayer Fiorinal Fiormor Fiortal Fortabs Genacote Genprin Halfprin Lifecoat Aspirin Low Dose ASA Magnaprin Med Aspirin Norwich Aspirin Pain Relief (Effervescent) Pain Relief with Aspirin Pravigard Pravigard PAC Sloprin St. Joseph Aspirin Stanback Analgesic Bayer Tri Buffered Aspirin Uni-As Uni-Buff Uni-Tren Zorprin

Specifications Manual for National Appendix C-3 Hospital Quality Measures

Release Notes: ACEI Table Version 1.0

Table 1.2 ACEIs Accupril Accuretic Aceon Altace Benazepril Benazepril Hydrochloride Benazepril/amlodipine Benazepril/hydrochlorothiazide Capoten Capozide Capozide 25/15 Capozide 25/25 Capozide 50/15 Capozide 50/25 Captopril HCT Captopril/hydrochlorothiazide Enalapril Enalapril Maleate/diltiazem Enalapril Maleate/hydrochlorothiazide Enalapril/diltiazem Enalapril/felodipine Enalapril/hydrochlorothiazide Enalaprilat Fosinopril / hydrochlorothiazide Lexxel Lisinopril Lisinopril/hydrochlorothiazide Lotensin Lotensin HCT Lotrel Mavik Moexipril Moexipril Hydrochloride Moexipril Hydrochloride/hydrochlorothiazide Moexipril/hydrochlorothiazide Monopril Monopril HCT Monopril HCT 10/12.5 Perindopril Perindopril erbumine

Specifications Manual for National Appendix C-4 Hospital Quality Measures

Table 1.2 ACEIs (continued) Prinivil Prinzide Quinapril Quinapril HC1 Quinapril HC1/HCT Quinapril Hydrochloride/hydrochlorothiazide Quinapril/hydrochlorothiazide Ramipril Tarka Teczem Trandolapril Trandolapril/verapamil Trandolapril/verapamil hydrochloride Uniretic Univasc Vaseretic Vasotec Zestoretic Zestril

Specifications Manual for National Appendix C-5 Hospital Quality Measures

Release Notes: Beta Blockers Table Version 1.0

Table 1.3 Beta Blockers Acebutolol Atenolol Atenolol/chlorthalidone Betapace Betapace AF Betaxolol Bisoprolol Bisoprolol/fumarate Bisopropol/hydrochlorothiazide Blocadren Brevibloc Carteolol Cartrol Carvedilol Coreg Corgard Corzide 40/5 Corzide 80/5 Esmolol Inderal Inderal LA Inderide Inderide LA Kerlone Labetalol Levatol Lopressor Lopressor HCT Lopressor/hydrochlorothiazide Metoprolol Metoprolol/hydrochlorothiazide Metoprolol Tartrate/hydrochlorothiazide Nadolol Nadolol/bendroflumethiazide Normodyne Penbutolol Pindolol Propranolol Propranolol HC1 Propranolol Hydrochloride Propranolol/hydrochlorothiazide Sectral Sorine Sotalol Sotalol HC1

Specifications Manual for National Appendix C-6 Hospital Quality Measures

Table 1.3 Beta Blockers (cont.) Tenoretic Tenormin Tenormin I.V. Timolide Timolol Timolol Maleate/hydrochlorothiazide Timolol/hydrochlorothiazide Toprol Toprol-XL Trandate Trandate HCl Visken Zebeta Ziac

Specifications Manual for National Appendix C-7 Hospital Quality Measures

Release Notes: Table Version 1.0

Table 1.4 Warfarin Barr Warfarin Sodium Coumadin Dicumarol Jantoven Liquamar Marevam Miradon Panwarfin Warfarin

Release Notes: Thrombolytic Table Version 1.0 Table 1.5 Thrombolytic Agents Abbokinase Activase Anisoylated Plasminogen- Activator Complex APSAC Eminase Kabikinase Retavase rPA (RPA) Streptase Streptokinase TNKase tPA (TPA) UK

Specifications Manual for National Appendix C-8 Hospital Quality Measures

Release Notes: Lipid Lowering Agents Table - Version 1.0

Table 1.6 Lipid Lowering Agents Abitrate Advicor Altocor Atorvastatin Atorvastatin/amlodipine Atromid-S B-3-50 B3-500-Gr Caduet Cholestyramine Cholestyramine Light Choloxin Clofibrate Colesevelam Colestid Colestid Flavored Colestipol Crestor Dextrothyroxine Sodium Ezetimibe Fenofibrate Fluvastatin Gemcor Gemfibrozil Lescol Lescol XL Lipitor Locholest Locholest Light Lofibra Lopid Lorelco Lovastatin Mevacor Niacin ER Niacin ER Starter Pack Niacin Extended Release Niacin SR Niacin TD Niacin TR Niacor Niacor B3 Niaspan Niaspan ER Niaspan ER Starter Pack

Specifications Manual for National Appendix C-9 Hospital Quality Measures

Table 1.6 Lipid Lowering Agents (cont.) Nico-400 Nicobid Tempules Nicolar Nicotinex Nicotinic Acid Pravachol Pravachol/aspirin Pravastatin Pravastatin/aspirin Pravigard Pravigard PAC Prevalite Prevalite Powder Probucol Questran Questran Light Rosuvastatin Simvastatin Slo-Niacin Tricor Welchol Zetia Zocor

Specifications Manual for National Appendix C-10 Hospital Quality Measures

Release Notes: Antimicrobial Medications Table Version 1.0 Table 2.1 Antimicrobial Medications Table Abacavir Abacavir Sulfate Achromycin Achromycin V Acyclovir Acyclovir Sodium Adoxa Agenerase Alatrofloxacin Alatrofloxacin Mesylate Amantadine Amantadine Hydrochloride Ambisome Amficot Amikacin Sulfate Amikin Amoxicillin (astryhydrate) Amoxicillin/Clavulanate Potassium Amoxicillin Trihydrate Amoxicillin as Trihydrate Amoxicillin (trihydrate) Amoxil Amoxil Pediatric Drops Amoxillin Amphocin Amphotec Amphotericin-B Ampicillin (Anhydrous) Ampicillin-Probenecid Ampicillin Sodium Ampicillin- Ampicillin Trihydrate Ampicin Amprenavir Ancef Anspor Not Otherwise Specified (NOS) Apo-Ampi Apo-Sulfatrim Aralen HCL Aralen

Specifications Manual for National Appendix C-11 Hospital Quality Measures

Table 2.1 Antimicrobial Medications Table (cont.) Atovaquone Augmentin Augmentin XR Avelox Avlosulfon Azactam Azulfidine Bacampicillin Hydrochloride Baci-IM Bactocill Bactrim Bactrim DS Beepen-VK Biaxin Biaxin XL Bicillin-C-R Bicillin L-A Biocef Biomox C-Lexin Carbenicillin Indanyl Sodium Ceclor Ceclor CD Ceclor Pulvules Cedax Cefaclor ER Cefadroxil Monohydrate Cefadyl Cefamandole Nafate Cefanex Cefazolin Sodium Cefditoren Pivoxil Cefepime Hydrochloride

Specifications Manual for National Appendix C-12 Hospital Quality Measures

Table 2.1 Antimicrobial Medications Table (cont.) Cefizox Cefmetazole Sodium Cefobid Cefonicid Sodium Cefoperazone Sodium Cefotan Cefotaxime Sodium Cefotetan Disodium Cefoxitin Sodium Cefpodoxime Proxetil Ceftazidime Sodium Ceftin Ceftizoxime Sodium Ceftriaxone Sodium Cefuroxime Sodium Cefzil Cephalexin Cephalexin Hydrochloride Cephalexin Monohydrate Cephalothin Cephalothin Sodium Cephapirin Cephapirin Sodium Cephradine Cephradine Sodium Ceptaz Chloroquine Cilastatin Cilastatin Sodium Cipro Cipro IV Ciprofloxacin Hydrochloride Claforan

Specifications Manual for National Appendix C-13 Hospital Quality Measures

Table 2.1 Antimicrobial Medications Table (cont.) Clavulanate Potassium Cleocin Cleocin HCL Cleocin Phosphate Clindamycin Hydrochloride Clindamycin Phosphate Cloxacillin Sodium Cloxapen Combivir Co-Trimoxazone Cotrim Cotrim DS Crystapen Cytovene Declomycin Dicloxacillin Sodium Diflucan Dirithromycin Doryx Doxy Caps Doxycycline Doxycycline Hyclate Doxycycline Hydrochloride Doxycycline Monohydrate Duricef Dycill Dynabac Dynacin Dynapen E-Mycin Ed A-Ceph EES E.E.S EES 200 EES 200/400 EES 400 Ertapenem Sodium Eryc EryPed EryPed 200 EryPed 200/400 EryPed 400

Specifications Manual for National Appendix C-14 Hospital Quality Measures

Table 2.1 Antimicrobial Medications Table (cont.) Erytab Erythrocin Erythromycin Base Erythromycin Estolate Erythromycin Ethylsuccinate Erythromycin Lactobionate Erythromycin Stearate Erythromycin/Sulfisoxazole Factive Famciclovir Famvir Flagyl Flagyl IV Floxin Floxin IV fluconazole Fluconazole Fortaz Furadantin Furalan Furatoin G-Mycin Ganciclovir Ganciclovir Sodium Gantanol Gantrisin Garamycin Gentamicin Sulfate Gentamicin Sulfate Sodium Chloride Geocillin HIVID Ilosone Ilotycin Imipenem-Cilastatin Invanz Kanamycin Kantrax Kantrex Keflet Keflex Keflin Keftab Kefurox

Specifications Manual for National Appendix C-15 Hospital Quality Measures

Table 2.1 Antimicrobial Medications Table (cont.) Kefzol Ketek Lariam Ledercillin VK Levaquin Lincocin Lomefloxacin Hydrochloride Lorabid Lorabid Pulvules Macrobid Macrodantin Mandol Marcillin Maxaquin Maxipime Mefloquine Mefloquine Hydrochloride Mefoxin Mepron Merrem Merrem IV Methicillin Sodium Metizol Mezlin Mezlocillin Sodium Minocin Minocycline HCL Monocid Monodox Moxifloxacin Hydrochloride Mycifradin Mycostatin Nafcil Nafcillin Sodium Nallpen Nebcin

Specifications Manual for National Appendix C-16 Hospital Quality Measures

Table 2.1 Antimicrobial Medications Table (cont.) Neggram Neo-fradin Neomycin Sulfate Neo-Tabs Nilstat Nizoral Noroxin Novo Ampicillin Novodoxylin Nu-Ampi Nystatin Omnicef Omnipen Omnipen-N Oseltamivir Oseltamivir Phosphate Oxacillin Sodium Panmycin Pathocil PC Pen VK PCE Pediazole Pen Vee K Pen-V Penbritin Penicillin G Penicillin G Benzathine Penicillin G Potassium Penicillin G Procaine Penicillin G Sodium Penicillin V Penicillin V Potassium Permapen Pfizerpen Piperacillin Sodium Piperacillin- Pipracil Plaquenil Plaquenil Sulfate Polycillin

Specifications Manual for National Appendix C-17 Hospital Quality Measures

Table 2.1 Antimicrobial Medications Table (cont.) Polycillin-PRB Polymox Primaxin Primaxin IM Primaxin IV Principen Proloprim Prostaphlin Protostat Quinupristin/Dalfopristin Raxar Relenza Retrovir Rifadin Rifadin IV Rifampin Rimactane Robicillin VK Robimycin Rocephin Rocephin IM Convenience Kit Senox Septra Septra DS Septra IV SMZ-TMP Spectrobid Spectracef Staphcillin Stavudine Streptograminis Streptomycin sulfate Sulbactam sodium Sulfamethoxazole Sulfasalazine Sulfasoxazole Sulfatrim Sulfisoxazole Sulfisoxazole/Erythromycin Ethylsuccinate Sumycin Suprax Symmetrel Synercid TAO Tamiflu

Specifications Manual for National Appendix C-18 Hospital Quality Measures

Table 2.1 Antimicrobial Medications Table (cont.) Tamivir Tazicef Tazidime Tazobactam Tazobactam Sodium TCN TEC-PAQ Tegopen Tequin Terramycin Tetracycline Hydrochloride Ticar Ticarcillin-Clavulanate Ticarcillin Disodium Timentin Tobi Tobra Tobramycin Sulfate Totacillin Totacillin-N Trimethoprim Trimox Trimpex Trovafloxacin/Alatrofloxacin Trovafloxacin Mesylate Trovan Ultracef Unasyn Unipen Uroplus DS Uroplus SS V-Cillin K Vancocin Vancoled Vancomycin Hydrochloride Vantin Vectrin Veetids Velosef Vibramycin Vibra-Tabs Wycillin

Specifications Manual for National Appendix C-19 Hospital Quality Measures

Table 2.1 Antimicrobial Medications Table (cont.) Wymox ZDV+3TC Z-pak Zagam Zalcitabine Zanamivir Zefazone Zerit Ziagen Zidovudine Zinacef Zithromax Zithromax TRI-PAK Zolicef Zosyn Zosyn Add-Vantage Zovirax Zyvok Zyvox

Specifications Manual for National Appendix C-20 Hospital Quality Measures

Release Notes: Immunosuppressive Medications Table Version 1.0 Table 2.2 Immunosuppressive Medications 141W94 1592U89 3TC 5 + 2 5-FU 7 +3 Abacavir ABC ABT-378 ABV AC Ace Acetocot Acthrel Actinomycin D Adbeon Adefovir ADF Adlone-40 Adlone-80 Adrenocot Adrenocot L.A. Adriamycin PFS Adriamycin RDF Adriamycin RDF/PFS Adrucil AF1549 Agenerase A-Hydrocort Aldesleukin Alferon N Alkeran Alkeran I.V. Amcort Amdoxovir A-Methapred Amethopterin Amifostine Amprenavir AP Antithymocyte Globulin APV Arabinasyl Cytosine Ara-C Arimidex

Specifications Manual for National Appendix C-21 Hospital Quality Measures

Aristocort Aristocort for Injection Aristocort Forte Aristopak Aristopan Injection Aromasin Atazanavir ATG Atrgam ATV Azasan Azathioprine Azathioprine sodium AZT Basiliximab BCG BCNU BCVPP BEP Betamethasone acetate Betamethasone Dipropionate Betamethasone Dipropionate Powder Betamethasone Sodium Phosphate Beta-Phos/AC Bexxar BiCNU BiCnu BIP Bis-Pom PMEA Blenoxane Bleomycin Sulfate BOMP CAE CAF CAL-G CAM Camptosar CAP Capravirine Carimune Specifications Manual for National Appendix C-22 Hospital Quality Measures

CAV CAVE CBV CC CCNU CDDP/VP Ceenu CeeNu Celestone Celestone Phosphate Celestone Soluspan Cellcept Cerubidine CEV CF CFM CHAP ChIVPP ChIVPP/EVA CHOP CHOP-BLEO Chromic phosphate P32 CISCA CISCA/VB Cisplatinum Citrororum Factor CMF CMFP CMFVP Combivir COMLA COMP COP COPE COPP Cortef Corticorelin corticorelin ovine (as trifluoracetate) Cort-K Cortone Acetate Cortrosyn Cosmegan Cosmegen cosyntropin Cotolone Coviracil CP Specifications Manual for National Appendix C-23 Hospital Quality Measures

Crixivan CT Curretab CVD CVI CVP CVPP Cyclophosphamide Lyophilized Cyclosporine Cyclosporine A Cycrin Cystosine Arabinoside Cytosar-U Cytoxan Cytoxan Lyophilized D4T DA Daclizumab DAL Dalalone Dalalone D.P. Dalalone L.A. DAPD Darcarbazine DAT Daunomycin Daunorubicin Citrate Liposome Daunorubicin Hydrochloride Daunorubicin Liposomal Daunoxome DaunoXome DAV DCT DDC DDI Decadron Decadron Phosphate, Injectable Decadron with Xylocaine Decadron-LA Deca-Durabolin Decaject Decaject L.A. Delatest Delatestryl Delavirdine Deltasone Dep Medalone 80 Specifications Manual for National Appendix C-24 Hospital Quality Measures

Depandro 100 Depmedalone Depoject-80 Depo-Medrol Depopred Depo-Predate De-Sone LA Dexacen-4 Dexacorten Dexamethasone Acetate Dexamethasone Intensol Dexamethasone Sodium Phosphate Dexamethasone Lidocaine Dexasone Dexasone LA Dexone Dexone LA Dexrazoxane DHAP DI Didanosine DLV DMP-266 Dororubicin Doxil Doxorubicin HCI Doxorubicin Hydrochloride Doxorubicin Hydrochlorideliposome Doxorubicin Liposomal Droxia Dtic-Dome DTIC-Dome Durabolin Durabolin-50 Duralone Duratest Durathate 200 DVP EAP EC EFP EFV ELF Eligard Elspar EMA 86 Emcyt Endoxan Specifications Manual for National Appendix C-25 Hospital Quality Measures

EP Epivir Ergamisol ESHAP Sodium Ethoyl Etopophos Etoposide (as Phosphate) EVA Everone FAC FAM FAMe FAMTX FAP Fareston F-CL FED Femara FK-506 FL Fle Florinef Acetate Fludara Fludarabine Phosphate Fludrocortisone Acetate Fluorouracil, Systemic FOAM Folex Folex PFS Folinic Acid Fortase FTC FTV FUDR FZ Gemcitabine HCI Gemtuzumab Gemzar Gliadel Goserelin Acetate Specifications Manual for National Appendix C-26 Hospital Quality Measures

Halotestin HDMTX Herceptin Hexadrol Hexadrol Phosphate Hexalen Hexamethylmelamine HIVID HN2 Hybolin Decanoate Hybolin-Improved Hycamtin Hydeltrasol Hydeltra-T.B.A. Hydrea Hydrocort SS Hydrocortisone Acetate Hydrocortisone Cypionate Hydrocortisone Sodium Phosphate Hydrocortisone Sodium Succinate Hydrocortone Hydrocortone Acetate Hydrocortone Phosphate Hydroxyurea Ibritumomab Idamycin Idarubicin HCl Idarubicin Hydrochloride IDV IE Ifex IfoVP Imuran Indinavir Interferon Alfa-2a Interferon Alfa-2b Interferon Alfa-n3 Intron A Intron A HAS Free Invirase Iodine I 131 Iodine I 131 Tositumomab Iodotope Kaletra Kenaject-40 Kenalog-10 Kenalog-40 Key-Pred Specifications Manual for National Appendix C-27 Hospital Quality Measures

Key-Pred SP KLT Lamivudine Leukeran Leukovoren Leuprolide Leuprolide Acetate Leustatin Levamisole Levamisole HCl Levamisole Hydrochloride Liquid Pred Lopinavir/Ritonavir LPV/RTV Lysodren M-2 MAID Matulane m-BACOD MBC MC Mechlorethamine Mechlorethamine HCl Mechlorethamine Hydorchloride Medicort Medidex Medidex LA Medipred Meditest Medralone Medralone 40 Medralone 80 Medrol Megestrol Mesnex Metastron Methotrexate LPF Methotrexate LPF Sodium Methotrexate Sodium Methylcotol Methylone 40 Methylone 80 Methylpredniso-lone Acetate Methylprednisol-One Sodium Succinate Meticorten Specifications Manual for National Appendix C-28 Hospital Quality Measures

MF MINE-ESHAP Mini-BEAM Mithracin Mithramycin Mitomycin Mitoxanthrone HCl Mitoxantrone Hydrochloride MIV MK-639 MOPP MOPP/ABV MP M- MTXCP-PDAdr Muromonab-CD3 Mustargen Mustargen HC Mutamycin MV M-VAC MVP MVPP Mycophenolate Mofetil Mycophenolate Mofetil Hydrochloride Myleran Navelbine Nelfinavir Neoral Neosar Nevirapine NFL NFV Nipent Nolvadex Norvir Novantrone NOVP NVP Oncaspar Oncovin OPA OPPA Orasone Orthoclone Okt 3 Oxandrin PAC Specifications Manual for National Appendix C-29 Hospital Quality Measures

Paclitaxel Paraplatin PC PCV Pediapred PFL Phenylalanine Mustard Phosphocol P32 Photofrin Platinol Platinol-AQ Platinol-Q PNU-14069 POC Porfimer Predacort 50 Predacorten Predaject-50 Predalone 50 Predate-50 Predcor Prednisolone Prednisolone Sodium Prelone Preveon Pri-Cortin 50 Primethasone Procarbazine HCl Procarbazine Hydrochloride Prograf Proleukin ProMACE ProMACE/cytaBOM Purinethol PVB PVDA PVP-16 Rapamune Rescriptor Retrovir Rheumatrex Rheumatrex Dose Pack Ritonavir Rituxan Rituximab Specifications Manual for National Appendix C-30 Hospital Quality Measures

Roferon-A Rubex RTV Samarium SM 153 Sandimmune Saquinavir Selestoject Simulect Sirolimus Sodcium Iodide I 131 Sodium Phosphate P32 Solu-Cortef Solu-Medrol Solurex Solurex LA SQV Stavudine Sterapred Sterapred DS Stilphostrol Streptozocin Strontiun-89 Chloride Sustiva TAC 3 Tacrolimus tamoxifen citrate Tarabine PFS Taxol Taxotere Taz Teslac TheraCys Theracys 3 TheraCys Intravesical Thioguanine Thioplex Thymoglobulin TICE BCG Tice BCG Vaccine Tipranavir Toposar Topotecan Hydrochoride Toremifene Citrate Specifications Manual for National Appendix C-31 Hospital Quality Measures

Tositumomab TPV Tramacort-D Trastuzumab Triam-A Triamcinolone Hexacetonide Triamcort Triam-Forte triamicinolone Acetonide Triamonide 40 Tri-Kort Trilog Trilone Tri-Med Tristoject Trizivir TZV Uracil Mustard U-Tri-Lone VAC VACAdr-lfoVP VAD VadrC VATH VBAP VC VCAP VCR VDA VDP Velban Velcade Vepesid VePesid Vercyte Vesanoid Videx Vinblastine Sulfate Vincristine Sulfate Vinorelbine Tartrate VIP VIP-1/2 Viracept Viramune VM Specifications Manual for National Appendix C-32 Hospital Quality Measures

VP16 V-TAD Vumon VX-478 Xeloda Zalcitabine Zanosar ZDV Zenapex Zerit Zevalin Ziagen Zidovudine Zoladex

Specifications Manual for National Appendix C-33 Hospital Quality Measures

Release Notes: Beta-Lactam Table Version 1.0

Table 2.3 Beta-Lactams Ampicillin-Sulbactam Cefotaxime Cefotaxime Sodium Ceftriaxone Ceftriaxone Sodium Claforan Rocephin Rocephin IM Convenience Kit Unasyn

Release Notes: Beta-Lactams (Pseudomonal Risk) Version 1.0 Table 2.4 Beta-Lactams (Pseudomonal Risk) Cefepime Cefepime Hydrochloride Imipenem Imipenem-Cilastatin Maxipime Meropenem Merrem Piperacillin-Tazobactam Primaxin Primaxin IV Zosyn Zosyn Add-Vantage

Release Notes: Table (Non-ICU) Version 1.0 Table 2.5 Macrolides (Non-ICU) Azithromycin Biaxin Biaxin XL Clarithromycin EES E.E.S. E-Mycin ERYC EryPed Erytab Erythromycin Erythromycin Base Erythromycin Estolate Erythromycin Ethylsuccinate Specifications Manual for National Appendix C-34 Hospital Quality Measures

Erythromycin Lactobionate Erythromycin Stearate Ilosone Ilotycin PCE Pediazole Robimycin Susfisoxazole/Erythromycin Ethylsuccinate Sufisoxazole/Erythromycin Ethylsuccinate Zithromax Zithromax TRI-PAK Z-pak

Release Notes: Macrolides Table (ICU) Version 1.0 Table 2.6 Macrolides (ICU) Azithromycin EES Eryped Erytab Erythromycin Erythromycin Base Erythromycin Estolate Erythromycin Ethylsuccinate Ilosone Ilotycin Pediazole Robimycin Susfisoxazole/Erythromycin Ethylsuccinate Sufisoxazole/Erythromycin Ethylsuccinate Zithromax Zithromax TRI-PAK Z-pak

Release Notes: Aztreonam Table (PN-Pseudomonal Risk/SIP-Colon or Hysterectomy β-lactam Allergy) Version 1.0

Table 2.7 Aztreonam (PN-Pseudomonal Risk/SIP-Colon or Hysterectomy β-lactam Allergy) Aztreonam Azactam

Specifications Manual for National Appendix C-35 Hospital Quality Measures

Release Notes: Quinolones Table (PN-Pseudomonal Risk/ Risk/SIP-Colon or Hysterectomy β-lactam Allergy ) Version 1.0

Table 2.8 Quinolones (PN-Pseudomonal Risk/SIP-Colon or Hysterectomy β-lactam Allergy) Cipro Ciprofloxacin Ciprofloxacin Hydrochloride Levaquin Levofloxacin

Release Notes: Quinolones Table Version 1.0 Table 2.9 Quinolones Avelox Gatifloxacin Levaquin Levofloxacin Moxifloxacin Moxifloxacin Hydrochloride Tec-Paq Tequin

Specifications Manual for National Appendix C-36 Hospital Quality Measures

Release Notes: Table Version 1.0

Table 2.10 Tetracyclines Doryx Doxycycline Doxycycline Calcium Doxycycline Hyclate Doxycycline Hydrochloride Doxycycline Monohydrate Monodox Novodoxylin Vibra-Tabs Vibramycin

Release Notes: Table (Pseudomonal Risk) Version 1.0 Table 2.11 Aminoglycosides (Pseudomonal Risk) Amikacin Amikacin Sodium Amikacin Sulfate Amikin Garamycin Gentamicin Gentamycin Sulfate Gentamicin Sulfate Gentamycin Sulfate-Sodium Chloride Gentamicin Sulfate Sodium Chloride Nebcin Tobra Tobramycin Tobramycin Sulfate

Release Notes: Clindamycin Table Version 1.0

Table 2.12 Clindamycin Cleocin Clindamycin Clindamycin Hydrochloride Clindamycin Phosphate

Specifications Manual for National Appendix C-37 Hospital Quality Measures

Release Notes: Glycopeptide Table Version 1.0

Table 2.13 Glycopeptides Vancocin Vancoled Vancomycin Vancomycin Hydrochloride

Release Notes: Cardiac or Vascular Antibiotic Table Version 1.0

Table 3.1 Cardiac or Vascular - Ancef Cefamandole Cefamandole Nafate Cefazolin Cefazolin Sodium Ceftin Cefuroxime Cefuroxime Axetil Cefuroxime Sodium Kefurox Kefzol Mandol Zinacef Zolicef

Release Notes: Hip/Knee Arthroplasty Antibiotic Table Version 1.0 Table 3.2 Hip/Knee Arthroplasty - Antibiotics Ancef Cefazolin Cefazolin Sodium Ceftin Cefuroxime Cefuroxime Axetil Cefuroxime Sodium Kefurox Kefzol Zinacef Zolicef

Specifications Manual for National Appendix C-38 Hospital Quality Measures

Release Notes: Colon - Oral Antibiotic Table Version 1.0 Table 3.3 Colon – Oral Antibiotics - I Mycifradin Neo-Fradin Neo-Tabs Neomycin Neomycin Sulfate

Release Notes: Colon – Oral Antibiotic Table Version 1.0 Table 3.4 Colon – Oral Antibiotics – II E-Mycin EES E.E.S. Eryc EryPed Erytab Erythrocin Erythromycin Erythromycin Base Erythromycin Estolate Erythromycin Ethylsuccinate Erythromycin Lactobionate Erythromycin Stearate Flagy Flagyl Ilosone Ilotycin Metizol Metronidazole PCE Pediazole Prostat Protostat Robimycin Sulfisoxazole/Erythromycin Ethylsuccinate

Specifications Manual for National Appendix C-39 Hospital Quality Measures

Release Notes: Colon - Parenteral Antibiotic Table Version 1.0 Table 3.5 Colon - Parenteral – Antibiotics - I Cefmetazole Cefmetazole Sodium Cefotan Cefotetan Cefotetan Disodium Cefotetan Cefozitin Cefoxitin Cefoxitin Sodium Mefoxin Zefazone

Release Notes: Colon - Parenteral Antibiotic Table Version 1.0 Table 3.6 Colon – Parenteral – Antibiotics - II Ancef Cefazolin Cefazolin Sodium Kefzol Zolicef

Release Notes: Colon - Parenteral Antibiotic Table Version 1.0 Table 3.6a Colon – Parenteral – Antibiotics - III Flagyl Metizol Metronidazole Protostat

Specifications Manual for National Appendix C-40 Hospital Quality Measures

Release Notes: Hysterectomy Antibiotic Table Version 1.0 Table 3.7 Hysterectomy – Antibiotics Ancef Cefazolin Cefazolin Sodium Cefotan Cefotetan Cefotetan Disodium Cefoxitin Cefoxitin Sodium Ceftin Cefuroxime Cefuroxime Axetil Cefuroxime Sodium Kefurox Kefzol Mefoxin Zinacef Zolicef

Release Notes: CABG, Cardiac or Vascular, Hip/Knee Arthroplasty Antibiotic Table Version 1.0

Table 3.8 CABG, Cardiac or Vascular, Hip/Knee Arthroplasty - Antibiotics Vancocin Vancoled Vancomycin Vancomycin Hydrochloride

Release Notes: CABG, Cardiac or Vascular, Hip/Knee Arthroplasty Antibiotic Table Version 1.0

Table 3.9 CABG, Cardiac or Vascular, Hip/Knee Arthroplasty, β-lactam allergic Colon and Hysterectomy - Antibiotics Cleocin Clindamycin Clindamycin Hydrochloride Clindamycin Phosphate

Specifications Manual for National Appendix C-41 Hospital Quality Measures

Release Notes: All Surgeries - Antibiotic Table Version 1.0

Table 3.10 All Surgeries – Antibiotics/Fluroquinolone Alatrofloxacin Ciprofloxacin Cipro IV Gatifloxacin Levaquin Levofloxacin Moxifloxacin Trovafloxacin/Alatrofloxacin Ofloxacin Tequin Trovafloxacin

Release Notes: Colon, Hysterectomy

β-lactam Allery-Antibiotc Table Version 1.0

Table 3.11 Colon, Hysterectomy β-lactam Allergy - Antibiotics Garamycin Gentamicin Gentamycin Sulfate Gentamicin Sulfate Gentamycin Sulfate-Sodium Chloride Gentamicin Sulfate Sodium Chloride

Release Notes: Antibiotic Allergy Table

Version 1.0 Table 4.0 Antibiotic Allergy Table Amficot Amoxicillin Amoxicillin Trihydrate Amoxicillin/Clavulanate-Potassium Amoxil Amoxil Pediatric drops Ampicillin Ampicillin as (Anhydrous) Ampicillin-Probenecid Ampicillin Sodium Ampicillin-Sulbactam Ancef Augmentin Bacampicillin Bacampicillin Hydrochloride Hydrochloride Bactocill Beepen-VK Benzylpenicillin Bicillin C-R Bicillin L-A Specifications Manual for National Appendix C-42 Hospital Quality Measures

Biocef Biomox C-Lexin Carbapenems Carbenicillin Carbenicillin Indanyl Sodium Ceclor Ceclor CD Ceclor Pulvules Cedax Cefaclor Cefadroxil Cefadroxil Monohydrate Monohydrate Cefadyl Cefamandole Cefamandole Naftate Nafate Cefanex Cefazolin Cefazolin Sodium Cefdinir Cefditoren Cefditoren Pivoxil Cefepime Cefepime Hydrochloride Hydrochloride Cefixime Cefizox Cefmetazole Cefmetazole Sodium Cefobid Cefonicid Cefonicid Sodium Cefoperazone Cefoperazone Sodium Cefotan Cefotaxime Cefotaxime Sodium Cefotetan Cefotetan Disodium Cefoxitin Cefoxitin Sodium Cefpodoxime Cefpodoxime Proxetil Cefprozil Ceftazidime Ceftazidime Sodium Ceftibuten Ceftin Ceftizoxime Ceftizoxime Sodium Ceftriaxone Ceftriaxone Sodium Cefuroxime Cefuroxime Axetil Cefuroxime Sodium Cefzil Cephalexin Cephalexin Hydrochloride Hydrochloride

Specifications Manual for National Appendix C-43 Hospital Quality Measures

Cephalexin Monohydrate Monohydrate Cephalothin Cephalothin Sodium Cephapirin Cephapirin Sodium Cephradine Ceptaz Cilastatin Sodium Claforan Clavulanate Potassium Cloxacillin Cloxacillin Sodium Cloxapen Combivir Dextrose-Mefoxin Dicloxacillin Dicloxacillin Sodium Duricef Dycill Dynapen Ed A-Ceph Ertapenem Fortaz Geocillin Imipenem Imipenem-Cilastatin Invanz Isoject Permapen Keflex Keflin Keftab Kefurox Kefzol Ledercillin VK Lorabid Lorabid Pulvules Loracarbef Mandol Marcillin Maxipime Mefoxin Meropenem Merrem Methicillin Methicillin Sodium Mezlin Mezlocillin Mezlocillin Sodium Monocid Nafcillin Nafcillin Sodium Nallpen Novo Ampicillin Nu-Ampi Omnicef Omnipen Omnipen-N Oxacillin Oxacillin Sodium

Specifications Manual for National Appendix C-44 Hospital Quality Measures

PC Pen VK Pen-V Pen Vee K Penicillin Penicillin G Penicillin G Benzathine Penicillin G Potassium Penicillin G Procaine Penicillin G Sodium Penicillin V Penicillin V Potassium Permapen Pfizerpen Piperacillin Piperacillin Sodium Piperacillin-Tazobactam Pipracil Polycillin-PRB Primaxin Principen Rocephin Rocephin IM Convenience Kit Senox Spectracef Spectrobid Staphcillin Sulbactam Sodium Suprax Tazicef Tazidime Tazobactam Sodium Tegopen Ticar Ticarcillin Ticarcillin Disodium Ticarcillin-Clavulanate Timentin Totacillin Totacillin-N Trimox Ultracef Unasyn Unipen Vantin V-Cillin K Veetids Velosef Wycillin Wymox ZDV+3TC Zefazone Zinacef Zolicef Zosyn Zosyn Add-Vantage

Specifications Manual for National Appendix C-45 Hospital Quality Measures