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Restricted Antimicrobials at Zuckerberg San Francisco General
All of the antimicrobials listed require approval by ID pharmacist or ID fellow, except for the routes and indications noted in the table below.
Contact information:
- ID Pharmacist: "ZSFG ID Pharmacist" on Epic secure chat (preferred) or pager 443-4379
- ID Fellow: 443-2847
Approval workflow for adult patients:
- Weekdays
- 0800 - 1630: contact ID pharmacist
- 1630 - 2000: contact ID fellow
- 2001 - 0759: Pharmacy will release overnight doses pending approval the next day
- Weekends & Holidays
- 0800 - 2000: contact ID fellow
- 2001 - 0759: Pharmacy will release overnight doses pending approval the next day
Approval workflow for neonates and pediatric patients:
- Weekdays
- 0800 - 1630: contact ID pharmacist
- 1631 - 0759: Pharmacy will release sufficient doses pending ID pharmacist review
- Weekends & Holidays
- All hours: Pharmacy will release sufficient doses pending ID pharmacist review
Restricted Antimicrobial |
Comments |
---|---|
Amikacin |
|
Amphotericin B (liposomal, conventional) |
Approval not required for: opthalmic injection and drops |
Artemether Lumefantrine (Coartem) | |
Artesunate | |
Aztreonam |
|
Ceftaroline |
|
Ceftazidime |
Approval not required for: opthalmic injection and drops |
Ceftazidime-Avibactam (Avycaz) | |
Ceftolozane-Tazobactam (Zerbaxa) | |
Clarithromycin |
Approval not required for: H pylori, MAC treatment or prophylaxis |
Daptomycin |
|
Ertapenem | Approval not required for: ESBL within past year, new ICU admission for sepsis |
Fidaxomicin (Dificid) | Approval not required for high-risk first episode CDI and all 1st recurrence. See ZSFG C. Difficile Guideline for details |
Foscarnet |
Approval not required for opthalmic injection |
Fosfomycin | |
Ganciclovir |
Approval not required for opthalmic injection |
Imipenem |
|
Isavuconazole | Approval not required for continuation of prior to admission therapy |
Itraconazole |
Approval not required for: Aspergillus, Histoplasma, eosinophilic folliculitis, bullous tinea and continuation of prior to admission therapy |
Linezolid |
Approval not required for: empiric necrotizing soft tissue infection (NSTI), IV formulation only |
Meropenem |
N/A |
Micafungin |
N/A |
Moxifloxacin |
Approval not required for opthalmic injection and/or drops |
Penicillin G Benzathine (Bicillin L-A) | ID approval required during shortage/recall (7/2025) |
Pentamidine |
|
Posaconazole |
Approval not required for continuation of prior to admission therapy |
Pyrimethamine | |
Rifampin |
Approval not required for: active or latent tuberculosis |
Tigecycline | |
Voriconazole |
Approval not required for: opthalmic injection and/or drops and continuation of prior to admission therapy |
Non-Formulary* |
|
*Non-formulary antimicrobials at ZSFG include, but are not limited to: Apretude (cabotegravir injection), Cabenuva (cabotegravir/rilpivirine injection), caspofungin, cefiderocol, colistin, lenacapavir, omadacycline, tedizolid