ORDER FORM
MIC Test Strips
Effective by: 01.01.2020
Date of update:
NO MIC Test Strip Name SYMBOL (MIC µg/ml) Box/Strip
1 Amikacin AK (0.016-256)
2 Ampicillin AM (0.016-256)
3 Ampicillin/sulbactam AMS (0.016-256)
4 Amoxcillin/clavulanic acid AMC (0.016-256)
5 Azithromycin AZ (0.016-256)
6 Aztreonam AT (0.016-256)
7 Cefaclor CF (0.016-256)
8 Cefepime PM (0.016-256)
9 Cefixime CFM (0.016-256)
10 Cefoperazone/sulbactam CPS (0.016-256)
11 Cefotaxime CT (0.002-32)
12 Cefotaxime CT-2 (0.016-256)
13 Cefotetan CN (0.016-256)
14 Cefoxitin FX (0.016-256)
15 Cefpodoxime PX (0.016-256)
16 Ceftazidime TZ (0.016-256)
17 Ceftibuten CBT (0.002-32)
18 Ceftizoxime CZ (0.002-32)
19 Ceftriaxone TX (0.002-32)
20 Cefuroxime XM (0.016-256)
21 Cephalothin CE (0.016-256)
22 Chloramphenicol CL (0.016-256)
23 Ciprofloxacin CI (0.002-32)
24 Clarithromycin CH (0.016-256)
25 Clindamycin CM (0.016-256)
26 Colistin CO (0.016-256)
27 Daptomycin DAP (0.016-256)
28 Doripenem DOR (0.002-32)
29 Doxycycline DC (0.016-256)
30 Enrofloxacin EF (0.002-32)
31 Ertapenem ETP (0.002-32)
32 Erythromycin EM (0.016-256)
33 Fusidic acid FU (0.016-256)
34 Fosfomycin FM (0.064-1024)
35 Gentamicin GM (0.016-256)
36 Kanamycin KM (0.016-256)
37 Levofloxacin LE (0.002-32)
38 Linezolid LZ (0.016-256)
39 Meropenem MP (0.002-32)
40 Mecillinam MM (0.002-32)
41 Minocycline MC (0.016-256)
42 Moxifloxacin MX (0.002-32)43 Nalidixic acid NA (0.016-256)
44 Netilmicin NET (0.016-256)
45 Nitrofurantoin NI (0.032-512)
46 Ofloxacin OF (0.002-32)
47 Oxacillin OX (0.016-256)
48 Penicillin PG (0.002-32)
49 Penicillin PG-2 (0.016-256)
50 Piperacillin PP (0.016-256)
51 Piperacillin/tazobactam TPZ (0.016-256)
52 Rifampicin RI (0.002-32)
53 Streptomycin SM (0.016-256)
54 Streptomycin SM-2 (0.064-1024)
55 Teicoplanin TP (0.016-256)
56 Tetracycline TC (0.016-256)
57 Ticarcillin/clavulanic acid TLC (0.016-256)
58 Tigecycline TGC (0.016-256)
59 Tobramycin TM (0.016-256)
60 Trimethoprim TR (0.002-32)
61 Trimethoprim/sulfamethoxazole TS (0.002-32)
62 Vancomycin VA (0.016-256)
63 Ceftriaxone TX-2 (0.016-256)
64 Cefepime/Cefepime+Clavulanic Acid (*) PM/PML (0.25-16/0.064-4)
65 Cefotaxime/Cefotaxime+Clavulanic Acid (*) CT/CTL (0.25-16/0.016-1)
66 Ceftazidime/Ceftazidime+Clavulanic Acid (*) TZ/TZL (0.5-32/0.064-4)
67 Cefotetan/Cefotetan+Cloxacillin (*) CN/CNX (0.5-32/0.5-32)
68 Amphotericin B AP (0.002-32)
69 Fluconazole FL (0.016-256)
70 Itraconazole IT (0.002-32)
71 Ketoconazole KE (0.002-32)
72 Posaconazole POS (0.002-32)
73 Pefloxacin PEF (0.002-32)
74 Norfloxacin NX (0.016-256)
75 Gatifloxacin GA (0.002-32)
76 Cefazolin CFZ (0.016-256)
ORDER DATE Unit of Order (mark by “X”)
Strip
Box *
Order Holder Order Held By (To Be Filled By BIOANALYSE)
Name/Surname : Person/Position:
Company Name : Signature:
Electronic signature :
Rev No/Tarih:00/… PS-FR-03
