UCSF Restricted Antimicrobials

AmBisome (liposomal amphotericin B)

Unrestricted Indications 1) Documented or suspected fungal pneumonia in a patient intolerant of or with contraindications to azoles 2) Prophylaxis against fungal infections in patients on the hematology/BMT service or lung transplant service 3) Empiric therapy for prolonged febrile neutropenia in hematology/oncology/BMT patient All other indications require approval from the Antimicrobial Stewardship Program or consulting ID fellow

Amikacin

All use of intravenous amikacin requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Artesunate

Non-formulary. Requires approval from ID consult service and pharmacy manager.

Baloxavir marboxil

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Caspofungin

Unrestricted Indications (select indication on order entry):

1) Documented sterile site (not urine or respiratory) infection  with microbiologically confirmed Candida glabrata or Candida kruseii

2) Documented sterile site infection (not urine or respiratory) infection with yeast, pending species identification

3) Prophylaxis against fungal infections in patients on the hematology/oncology/BMT service with intolerance of or contraindications to azoles

4) Empiric therapy for prolonged febrile neutropenia in hematology/oncology/BMT patient

All other indications require approval from the Antimicrobial Stewardship Program or consulting ID fellow

Cefiderocol

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Ceftaroline

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Ceftazidime/avibactam (Avycaz)

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Ceftolozane/tazobactam (Zerbaxa)

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Cidofovir

Unrestricted Indications (select on order entry):

1) Unrestricted use on the hematology/oncology/BMT service

All other use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Colistin IV

All use of IV colistin requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow.  Inhaled use of colistin is allowed for unrestricted use in prophylaxis in lung transplant.

Dalbavancin

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Daptomycin

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Eravacycline

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Fidaxomicin

All use requires authorization from the Antimicrobial Stewardship Program or the consulting ID fellow

Foscarnet

Unrestricted Indications (select on order entry):

1) Use on hematology/oncology/BMT service

All other use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Imipenem/cilastatin

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Imipenem/cilastatin/relebactam

All use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Isavuconazole

Unrestricted Indications: 1) Documented or suspected fungal pneumonia in a patient with prolonged QT interval 2) Prophylaxis against fungal infections on the hematology/oncology/BMT service or lung transplant service in a patient with prolonged QT interval All other use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

Letermovir

Unrestricted Indications (provide on order entry):

1) CMV prophylaxis on heme/BMT service

All other use requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow

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