AmBisome (liposomal amphotericin B) |
Restricted to ID or Antimicrobial Stewardship except: 1) Documented or suspected serious fungal infection 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 |
Amikacin |
Restricted to ID or Antimicrobial Stewardship for IV amikacin |
Artesunate |
Restricted to ID or Antimicrobial Stewardship |
Baloxavir marboxil |
Restricted to ID or Antimicrobial Stewardship |
Bezlotoxumab |
Restricted to ID or Antimicrobial Stewardship Additonal criteria for inpatient administration: Must be expected to be hospitalized > 14 days after C. difficile episode |
Cefiderocol |
Restricted to ID or Antimicrobial Stewardship |
Ceftaroline |
Restricted to ID or Antimicrobial Stewardship |
Ceftazidime/avibactam (Avycaz) |
Restricted to ID or Antimicrobial Stewardship |
Ceftolozane/tazobactam (Zerbaxa) |
Restricted to ID or Antimicrobial Stewardship |
Cidofovir |
Restrict to ID or Antimicrobial Stewardship except: 1) For treatment or prophylaxis against viral infection in a BMT patient |
Colistin IV |
Restricted to ID or Antimicrobial Stewardship *Inhaled use of colistin is allowed for unrestricted use in prophylaxis in lung transplant. |
Dalbavancin |
Restricted to ID or Antimicrobial Stewardship |
Daptomycin |
Restricted to ID or Antimicrobial Stewardship |
Eravacycline |
Restricted to ID or Antimicrobial Stewardship ZSFG: Non-formulary |
Fecal microbiota spores, live—brpk (Vowst) |
Restricted to ID/ASP for use in select adults with recurrent CDI who are expected to be hospitalized > 14 days after C. difficile episode. ZSFG: Non-formulary |
Foscarnet (CMV dosing) |
Restricted to ID or Antimicrobial Stewardship except 1) For treatment or prophylaxis against viral infection in BMT patient
|
Imipenem/cilastatin |
Restricted to ID or Antimicrobial Stewardship |
Imipenem/cilastatin/relebactam |
Restricted to ID or Antimicrobial Stewardship |
Isavuconazole |
Restricted to ID or Antimicrobial Stewardship except: 1) Documented or suspected serious fungal infection in a patient with prolonged QTc interval 2) Prophylaxis against fungal infections in patients on the hematology/BMT service or lung transplant service with prolonged QTc interval or concurrent QTc prolonging medications. |
Letermovir |
Restricted to ID or Antimicrobial Stewardship except for: 1) Adult malignant hematology service - for prophylaxis only per service guidelines ZSFG: Non-formulary |