<p> Effective by : 01/09/2003 (9001) / ORDER FORM (2016) 17/03/2010 (13485) Antimicrobial Susceptibility Testing Discs (ASTDs) Page No. : 1/7</p><p>ASTDs IN ROUTINE USE (1/4) ASTD Name SYMBOL mcg Quantit ASTD Name SYMBOL mcg Quantity y 1- Amikacin AK 30 39- Cefotaxime/clavulanic acid CTC 30/10 2- Aminosidin AN 60 40- Cefotaxime/sulbactam CTS 30/10 3- Amoxicillin AX 25 41- Cefotaxime/tazobactam TCX 30/10 4- Amoxicillin/clavulanic acid AMC 20/10 42- Cefotetan (*) CTT 30 5- Amphotericin B AMB 100 U 43- Cefotiam CTM 30 6- Ampicillin AM 10 44- Cefoxitin FOX 30 7- Ampicillin/cloxacillin APX 25/5 45- Cefoxitin/boronic acid (*) FOX/BA 430 8- Ampicillin/dicloxacillin AMD 11 46- Cefpirome CPO 30 9- Ampicillin/sulbactam SAM 10/10 47- Cefpodoxime CPD 10 10- Apramycin APR 15 48- Cefpodoxime/clavulanic acid CPC 10/1 11- Azithromycin AZM 15 49- Cefprozil CPR 30 12- Azlocillin AZL 75 50- Cefquinome CEQ 30 13- Aztreonam ATM 30 51- Cefsulodin (*) CFS 30 14- Bacitracin B 10 U 52- Ceftaroline (*) CPT 30 15- Bile Disc (*) BIL --- 53- Ceftazidime CAZ 30 16- Boronic acid (*) APB 300 54- Ceftazidime/ boronic acid (*) CAZ/BA 430 17- Boronic acid/cefotaxime(*) CTX/BA 430 55- Ceftazidime/clavulanic acid CZC 30/10 18- Boronic acid/cefoxitin (*) FOX/BA 430 56- Ceftazidime/tazobactam TCA 30/10 19- Boronic acid/ceftazidime (*) CAZ/BA 430 57- Ceftibuten (*) CBT 30 20- Boronic acid/meropenem (*) MEM/BA 600/10 58- Ceftiofur FUR 30 21- Carbenicillin PY 100 59- Ceftizoxime ZOX 30 22- Caspofungin (*) CAS 5 60- Ceftriaxone CRO 30 23- Cefaclor CEC 30 61- Ceftriaxone/clavulanic acid CFC 40 24- Cefadroxil CFR 30 62- Cefuroxime CXM 30 25- Cefamandole MA 30 63- Cefuroxime axetil CXA 30 26- Cefazolin CZ 30 64- Cephalexin CL 30 27- Cefdinir CD 5 65- Cephalonium (*) CNM 30 28- Cefditoren CDN 5 66- Cephalothin KF 30 29- Cefepime FEP 30 67- Cephradine CE 30 30- Cefepime/clavulanic acid FEC 40 68- Chloramphenicol C 30 31- Cefixime CFM 5 69- Chlortetracycline CHT 30 32- Cefmetazole CMZ 30 70- Ciclopirox olamine (*) CPX 50 33- Cefodizime CDZ 30 71- Cilastatin/imipenem(*) IMC 20 34- Cefonicid CID 30 72- Cinoxacin CIN 100 35- Cefoperazone CEP 75 73- Ciprofloxacin CIP 5 36- Cefoperazone/sulbactam CES 75/30 74- Clarithromycin CLR 15 37- Cefotaxime CTX 30 75- Clavulanic acid/amoxacillin AMC 30 38- Cefotaxime/boronic acid (*) CTX/BA 430 76- Clavulanic acid/cefepime FEC 40</p><p>Unit of Order (mark Order Date Order Holder by“X”) Cartridge Box Name/Surname : *Remarks (For the Order Holder) Company Name : Electronic Signature : (if available)</p><p>(*) Diffrent Price Order Held By (To Be Filled By BIOANALYSE ) Order Approved By (To Be Filled By BIOANALYSE) Person/Position: Person/Position: Signature: Signature:</p><p>Revision No./Date: 11/19.08.2014 PS-FR- 09 Effective by : 01/09/2003 (9001) / ORDER FORM (2016) 17/03/2010 (13485) Antimicrobial Susceptibility Testing Discs (ASTDs) Page No. : 2/7</p><p>ASTDs IN ROUTINE USE (2/4) ASTD Name SYMBOL mcg Quantit ASTD Name SYMBOL mcg Quantity 77- Clavulanic acid/cefotaxime CTC 40 y 115- Florfenicol FFC 30 78- Clavulanic acid/cefpodoxime CPC 11 116- Flucloxacillin FL 5 79- Clavulanic acid/ceftazidime CZC 40 117- Fluconazole FLU 25 80- Clavulanic acid/ceftriaxone CFC 40 118- Flucytosine 5FC 1 81- Clavulanic acid/ticarcillin TIM 85 119- Flumequine (*) FLM 30 82- Clinafloxacin CLX 5 120- Fosfomycin FF 50 83- Clindamycin DA 2 121- Fosfomycin/trometamol FOT 200 84- Clotrimazole CLT 10 122- Framycetin (*) FM 100 85- Cloxacillin CX 1 123- Furazolidone FX 100 86- Cloxacillin/ampicillin APX 30 124- Fusidic acid FA 10 87- Colistin CT 10 125- Garenoxacin (*) GRN 5 88- Dalfopristin/quinupristin (*) SYN 15 126- Gatifloxacin GAT 5 89- Danofloxacin (*) DAN 5 127- Gemifloxacin GEM 5 90- Daptomycin (*) DAP 30 128- Gentamicin CN 10 91- Dibekacin (*) DBK 10 129- Griseofulvin GRS 10 92- Dicloxacillin DCX 1 130- Imipenem IPM 10 93- Difloxacin DIF 10 131- Imipenem/cilastatin (*) IMC 10/10 94-Dirithromycin (*) DTM 15 132- Imipenem/EDTA (*) IEH 750 95- Doripenem (*) DOR 10 133- Imipenem/EDTA (*) IEL 292 96- Doxycycline DO 30 134- Imipenem/EDTA (*) IPE 10 97- Econazole ECO 10 135- Isepamicin ISP 30 98- EDTA (*) EDH 930 136- Isoniazid INH 1 99- EDTA (*) EDL 750 137- Itraconazole ITR 10 100- EDTA/ertapenem (*) EEH 750 138- Kanamycin K 30 101- EDTA/ertapenem (*) EEL 292 139- Kanamycin/cephalexin KCL 45 102- EDTA/imipenem (*) IEH 750 140- Ketoconazole KTC 10 103- EDTA/imipenem (*) IEL 292 141- Levofloxacin LEV 5 104- EDTA/imipenem (*) IPE 10 142- Lincomycin L 2 105- EDTA/meropenem (*) MEH 750 143- Lincomycin/neomycin LCN 15/60 106- EDTA/meropenem (*) MEL 292 144- Lincomycin/spectinomycin(*) LCS 9/100 107- EDTA/SMA (*) MBL 750 145- Linezolid LNZ 30 108- Enoxacin EN 10 146- Lomefloxacin LOM 10 109- Enrofloxacine ENR 5 147- Loracarbef LOR 30 110- Ertapenem (*) ETP 10 148- Marbofloxacin MAR 5 111- Ertapenem/EDTA(*) EEH 750 149- Mecillinam MEC 10 112- Ertapenem/EDTA(*) EEL 292 150- Meropenem MEM 10 113- Erythromycin E 15 151- Meropenem/boronic acid (*) MEM/BA 10/600 114- Fleroxacin FLE 5 152- Meropenem/EDTA (*) MEH 750</p><p>Unit of Order (mark Order Date Order Holder by“X”) Cartridge Box Name/Surname : *Remarks (For the Order Holder) Company Name : Electronic Signature : (if available) : </p><p>(*) Diffrent Price Order Held By (To Be Filled By BIOANALYSE ) Order Approved By (To Be Filled By BIOANALYSE) Person/Position: Person/Position: Signature: Signature:</p><p>Revision No./Date: 11/19.08.2014 PS-FR- 09 Effective by : 01/09/2003 (9001) / ORDER FORM (2016) 17/03/2010 (13485) Antimicrobial Susceptibility Testing Discs (ASTDs) Page No. : 3/7</p><p>ASTDs IN ROUTINE USE (3/4) ASTD Name SYMBOL mcg Quantit ASTD Name SYMBOL mcg Quantity y 153- Meropenem/EDTA (*) MEL 292 191- Pipemidic acid PI 20 154- Methicillin (*) ME 5 192- Piperacillin PRL 100 155- Metronidazole MET 5 193- Piperacillin/tazobactam TPZ 100/10 156- Mezlocillin MEZ 75 194- Pirlimycin PIR 2 157- Miconazole MCZ 10 195- Polymyxin B PB 300 U 158- Minocycline MI 30 196- Posaconazole POS 5 159- Moxalactam MOX 30 197- Pristinamycin PT 15 160- Moxifloxacin MXF 5 198- PYR (*) PYR --- 161- Mupirocin MUP 5 199- Quinupristin/dalfopristin (*) SYN 4.5/10.5 162- Nafcillin NAF 1 200- Rifampin RA 5 163- Nalidixic acid NA 30 201- Rifamycin SV RF 30 164- Neomycin N 30 202- Rifaximin RAX 40 165- Neomycin B (*) NB 10 203- Roxithromycin ROX 30 166- Neomycin/lincomycin LCN 75 204- Sarofloxacin SAR 5 167- Netilmicin NET 30 205- SMA/EDTA MBL 750 168- Nitrocefin (*) NIT --- 206- Sisomycin SIS 10 169- Nitrofurantoin F 300 207- Sodium polyanethol sulfonate (*) SPS ---- 170- Nitrofurazone NR 100 208- Sparfloxacin SPX 5 171- Nitroxoline NTX 30 209- Spiramycin SP 100 172- Norfloxacin NOR 10 210- Spectinomycin/lincomycin(*) LCS 109 173- Novobiocin NV 30 211- Streptomycin S 10 174- Novobiocin/penicillin PNV 40 212- Sulbactam/ampicillin SAM 20 175- Nystatin NY 100 U 213- Sulbactam/cefoperazone CES 105 176- O129 (*) O1/129 10 214- Sulfadiazine SD 300 177- Ofloxacin OFX 5 215- Sulfadiazine/ trimethoprim TS 30 178- Oleandomycin OL 15 216- Sulfathiazole STZ 300 179- ONPG (*) O/NPG --- 217- Sulfisoxazole ST 300 180- Orbifloxacin ORB 10 218- Sulphamethoxazole SMZ 100 181- Oxacillin OX 1 219- Sulphamethoxazole/ trimethoprim SXT 25 182- Oxidase (*) OXI --- 220- Tazobactam/cefotaxime TCX 10/30 183- Oxolinic acid OA 2 221- Tazobactam/ceftazidime TCA 10/30 184- Oxytetracycline T 30 222- Tazobactam/piperacillin TPZ 110 185- Paromomycin PRM 10 223- Teicoplanin TEC 30 186- Pefloxacin PEF 5 224- Telithromycin (*) TEL 15 187- Penicillin P 10U 225- Temocillin (*) TEM 30 188- Penicillin V PV 10U 226- Terbinafine (*) TRB 30 189- Penicillin/novobiocin PNV 40 227- Tetracycline TE 30 190- Pimaricin PIM 10 228- Thiamphenicol TP 30</p><p>Unit of Order (mark by“X”) Order Date Order Holder Cartridge Box Name/Surname : *Remarks (For the Order Holder) Company Name : Electronic Signature : (if available) </p><p>(*) Diffrent Price Order Held By (To Be Filled By BIOANALYSE ) Order Approved By (To Be Filled By BIOANALYSE) Person/Position: Person/Position: Signature: Signature:</p><p>Revision No./Date: 11/19.08.2014 PS-FR- 09 Effective by : 01/09/2003 (9001) / ORDER FORM (2016) 17/03/2010 (13485) Antimicrobial Susceptibility Testing Discs (ASTDs) Page No. : 4/7</p><p>OTHER ASTDs (4/4) ASTD Name SYMBOL mcg Quantit IDENTIFICATION (DIFFERANTIATION) DISCS: y 229- Ticarcillin TIC 75 1- Bacitracin (*) B 0.04 U 230- Ticarcillin/clavulanic acid TIM 75/10 2- Cefoxitin (*) FOX 10 231- Tigecycline (*) TGC 15 3- Kanamycin (*) K 1000 232- Tilmicosin TIL 15 4- Metronidazole (*) MET 50 233- Tobramycin TOB 10 5- Optochin (*) OP 5 234- Trimethoprim TMP 5 6- Spectinomycin (*) SPT 100 235-Trimethoprim/sulfadiazine TS 5/25 236- Trimethoprim/ 1.25/ SXT sulphamethoxazole 23.75 237- Triple sulphonamides S3 300 238- Trometamol/fosfomycin FOT 200 239- Tulathromycin TUL 30 240- Tylosin TY 15 241- Vancomycin VA 30 242- Virginamycin VIR 15 243- Voriconazole VOR 1 244- X factor disc (*) X ---- 245- V factor disc (*) V ---- 246- X + V factor disc (*) X + V ----</p><p>Unit of Order (mark by“X”) Order Date Order Holder Cartridge Box Name/Surname : *Remarks (For the Order Holder) Company Name : Electronic Signature : (if available) </p><p>(*) Diffrent Price Order Held By (To Be Filled By BIOANALYSE ) Order Approved By (To Be Filled By BIOANALYSE) Person/Position: Person/Position: Signature: Signature:</p><p>Revision No./Date: 11/19.08.2014 PS-FR- 09 Effective by : 01/09/2003 (9001) / ORDER FORM (2016) 17/03/2010 (13485) Antimicrobial Susceptibility Testing Discs (ASTDs) Page No. : 5/7</p><p>OTHER ASTDs (1/3) ASTD Name SYMBOL mcg Quantity ASTD Name SYMBOL mcg Quantity 1- Amikacin AK 10 39- Chloramphenicol C 5 2- Amoxicillin AX 2 40- Ciprofloxacin CIP 1 3- Amoxicillin AX 10 41- Ciprofloxacin CIP 10 4- Amoxicillin AX 30 42- Ciprofloxacin CIP 30 5- Amoxicillin/clavulanic acid AMC 2/1 43- Ciprofloxacin CIP 50 6- Amphotericin B AMB 20 U 44- Clarithromycin CLR 2 7- Ampicillin AM 2 45- Clarithromycin CLR 5 8- Ampicillin AM 20 46- Clavulanic acid/amoxicillin AMC 3 9- Ampicillin AM 25 47- Clavulanic acid/cefotaxime CTC 15 10- Ampicillin AM 30 48- Clavulanic acid/cefpodoxime (*) CPC 40 11- Ampicillin/sulbactam SAM 20/10 49- Clavulanic acid/ceftazidime CZC 20 12- Apramycin APR 30 50- Clindamycin DA 10 13- Azithromycin AZM 30 51- Clindamycin DA 15 14- Azlocillin AZL 30 52- Clotrimazole CLT 20 15- Boronic acid (*) APB 250 53- Clotrimazole CLT 50 16- Boronic acid (*) APB 400 54- Clotrimazole (*) CLT 300 17- Carbenicillin PY 10 55- Cloxacillin CX 5 18- Carbenicillin PY 25 56- Cloxacillin CX 10 19- Cefaclor CEC 10 57- Cloxacillin CX 25 20- Cefdinir (*) CD 30 58- Cloxacillin CX 30 21- Cefdinir (*) CD 50 59- Cloxacillin (*) CX 500 22- Cefepime FEP 5 60- Colistin CT 25 23- Cefepime FEP 10 61- Colistin CT 50 24- Cefixime CFM 10 62- Colistin CT 100 25- Cefixime CFM 30 63- Doxycycline DO 10 26- Cefoperazone CEP 30 64- Econazole ECO 50 27- Cefotaxime CTX 5 65- Enrofloxacin ENR 10 28- Cefotaxime CTX 10 66- Erythromycin E 5 29- Cefoxitin (*) FOX 10 67- Erythromycin E 10 30- Cefpodoxime (*) CPD 30 68- Erythromycin E 30 31- Cefpodoxime/clavulanic acid (*) CPC 40 69- Erythromycin E 60 32- Cefquinome CEQ 10 70- Fluconazole FLU 10 33- Ceftazidime CAZ 10 71- Fluconazole FLU 50 34- Ceftriaxone CRO 5 72- Fluconazole (*) FLU 100 35- Ceftriaxone CRO 10 73- Fosfomycin FF 30 36- Cefuroxime CXM 5 74- Fosfomycin FF 200 37- Cefuroxime axetil CXA 10 75- Fosfomycin/trometamol FOT 50 38- Cephalotin KF 5 76- Furazolidone FX 15</p><p>Unit of Order (mark by“X”) Order Date Order Holder Cartridge Box Name/Surname : *Remarks (For the Order Holder) Company Name : Electronic Signature : (if available)</p><p>(*) Diffrent Price</p><p>Order Held By (To Be Filled By BIOANALYSE ) Order Approved By (To Be Filled By BIOANALYSE) Person/Position: Person/Position: Signature: Signature:</p><p>Revision No./Date: 11/19.08.2014 PS-FR- 09 Effective by : 01/09/2003 (9001) / ORDER FORM (2016) 17/03/2010 (13485) Antimicrobial Susceptibility Testing Discs (ASTDs) Page No. : 6/7</p><p>OTHER ASTDs (2/3) ASTD Name SYMBOL mcg Quantity ASTD Name SYMBOL mcg Quantity 77- Furazolidone FX 50 115- Miconazole MCZ 50 78- Fusidic acid FA 5 116- Minocycline MI 25 79- Fusidic acid FA 30 117- Moxifloxacin MXF 1 80- Fusidic acid FA 50 118- Mupirocin MUP 20 81- Gatifloxacin GAT 10 119- Mupirocin (*) MUP 200 82- Gatifloxacin GAT 30 120- Neomycin N 5 83- Gentamicin CN 15 121- Neomycin N 10 84- Gentamicin CN 30 122- Netilmicin NET 5 85- Gentamicin CN 50 123- Netilmicin NET 10 86- Gentamicin CN 120 124- Nitrofurantoin F 50 87- Gentamicin CN 200 125- Nitrofurantoin F 100 88- Gentamicin (*) CN 250 126- Nitrofurantoin F 200 89- Gentamicin (*) CN 500 127- Nitroxoline NTX 20 90- Isoniazid INH 5 128- Norfloxacin NOR 2 91- Itraconazole ITR 50 129- Norfloxacin NOR 5 92- Kanamycin K 2 130- Norfloxacin NOR 30 93- Kanamycin K 5 131- Novobiocin NV 5 94- Kanamycin K 50 132- Novobiocin NV 10 95- Kanamycin (*) K 1000 133- O129 (*) O2/129 150 96- Ketoconazole KTC 50 134- Ofloxacin OFX 1 97- Levofloxacin LEV 1 135- Nitrofurantoin F 200 98- Levofloxacin LEV 15 136- Nitroxoline NTX 20 99- Lincomycin L 10 137- Norfloxacin NOR 2 100- Lincomycin L 15 138- Norfloxacin NOR 5 101- Lincomycin (*) L 30 139- Norfloxacin NOR 30 102- Linezolid LNZ 5 140- Novobiocin NV 5 103- Linezolid LNZ 10 141- Novobiocin NV 10 104- Lomefloxacin LOM 30 142- O129 (*) O2/129 150 105- Loracarbef LOR 10 143- Ofloxacin OFX 2 106- Mecillinam (*) MEC 25 144- Ofloxacin OFX 10 107- Methicillin (*) ME 10 145- Oxacillin OX 5 108- Methicillin (*) ME 30 146- Oxacillin OX 10 109- Metronidazole MET 2.5 147- Penicillin P 1 U 110- Metronidazole MET 4 148- Penicillin P 1.5 U 111- Metronidazole MET 10 149- Penicillin P 2 U 112- Metronidazole MET 30 150- Penicillin P 5 U 113- Metronidazole MET 80 151- Pipedemic acid PI 2 114- Mezlocillin MEZ 30 152- Pipemidic acid PI 30</p><p>Unit of Order (mark by“X”) Order Date Order Holder Cartridge Box Name/Surname : *Remarks (For the Order Holder) Company Name : Electronic Signature : </p><p>Order Held By (To Be Filled By BIOANALYSE ) Order Approved By (To Be Filled By BIOANALYSE) Person/Position: Person/Position: Signature: Signature:</p><p>Revision No./Date: 11/19.08.2014 PS-FR- 09 Effective by : 01/09/2003 (9001) / ORDER FORM (2016) 17/03/2010 (13485) Antimicrobial Susceptibility Testing Discs (ASTDs) Page No. : 7/7</p><p>(if available)</p><p>(*) Diffrent Price</p><p>OTHER ASTDs (3/3) ASTD Name SYMBOL mcg Quantity ASTD Name SYMBOL mcg Quantity 153- Piperacillin PRL 30 191- Trimethoprim TMP 10 154- Piperacillin PRL 75 192- Trimethoprim TMP 25 155- Piperacillin/tazobactam TPZ 30/6 193- Trimethoprim TMP 30 156- Piperacillin/tazobactam TPZ 30/10 194- Triple sulphonamides S3 250 157- Piperacillin/tazobactam TPZ 75/10 195- Triple sulphonamides S3 300 158- Polymyxin B PB 50 U 196- Triple sulphonamides S3 1000 159- Polymyxin B PB 100 U 197- Trometamol/fosfomycin FOT 50 160- PYR PYR ---- 198- Tylosin TY 30 161- Rifampin RA 1 199- Tylosin TY 60 162- Rifampin RA 2 200- Vancomycin VA 5 163- Rifampin RA 15 201- Vancomycin VA 10 164- Rifampin RA 30 165- Roxithromycin ROX 15 166- Sparfloxacin SPX 10 167- Spectinomycin SPT 10 168- Spectinomycin SPT 25 169- Spiramycin SP 10 170- Spiramycin SP 30 171- Streptomycin S 25 DOMESTIC EQUIPMENTS: 172- Streptomycin (*) S 300 1- Blank disk in Cartridge(*) BLK/CR ---- 173- Streptomycin (*) S 500 2- Blank disk in Sachet(*) BLK/SC ---- 174- Sulbactam/ampicillin SAM 30 3- Dispenser (old version) (*) DSP ---- 175- Sulfadiazine SD 100 4- Illuminator (Zonmeter) (*) ZON ---- 176- Sulfisoxazole ST 30 5- Trigger (single dispenser) (*) TRG ---- 177- Sulfisoxazole ST 250 6- Dispenser (8 magazine) (*) DSP-8 --- 178- Sulphamethoxazole SMZ 25 7- Dispenser (6 magazine) (*) DSP-6 --- 179- Sulphamethoxazole SMZ 50 180- Sulphamethoxazole SMZ 200 181- Sulphamethoxazole SMZ 300 182- Tazobactam/piperacillin TPZ 36 IDENTIFICATION STRIPS: 183- Tazobactam/piperacillin TPZ 40 1-Oxidase Strip (*) OXI/S ---- 184- Tazobactam/piperacillin TPZ 85 2-PYR Strip (*) PYR/S ---- 185- Tetracycline TE 5 186- Tetracycline TE 10 187- Tetracycline TE 25 188- Tobramycin TOB 30 189- Trimethoprim TMP 1.25 190- Trimethoprim TMP 2.5</p><p>Unit of Order (mark by“X”) Order Date Order Holder Cartridge Box Name/Surname : Company Name : </p><p>Order Held By (To Be Filled By BIOANALYSE ) Order Approved By (To Be Filled By BIOANALYSE) Person/Position: Person/Position: Signature: Signature:</p><p>Revision No./Date: 11/19.08.2014 PS-FR- 09 Effective by : 01/09/2003 (9001) / ORDER FORM (2016) 17/03/2010 (13485) Antimicrobial Susceptibility Testing Discs (ASTDs) Page No. : 8/7</p><p>Electronic Signature : (if available)</p><p>(*) Diffrent Price</p><p>Order Held By (To Be Filled By BIOANALYSE ) Order Approved By (To Be Filled By BIOANALYSE) Person/Position: Person/Position: Signature: Signature:</p><p>Revision No./Date: 11/19.08.2014 PS-FR- 09</p>