UCSF Adult Restricted Antimicrobials

Meropenem/vaborbactam

Restricted to ID or Antimicrobial Stewardship

Micafungin

Restricted to ID or Antimicrobial Stewardship except:

1) Documented sterile site (not urine or respiratory) infection  with microbiologically confirmed Candida spp (ID/ASP approval required for durations exceeding 48h)

2) Documented sterile site infection (not urine or respiratory) infection with yeast, pending species identification (ID/ASP approval required for durations exceeding 48h)​

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

Miltefosine

Restricted to ID or Antimicrobial Stewardship with exceptions:

1) Continuation of therapy 

ZSFG: Non-formulary

Nirmatrelvir/ritonavir (Paxlovid)

Restricted to ASP or ID consult service (with exceptions):

- Inpatients (or those in the ED pending admission) with mild-moderate COVID-19 with symptom onset within 5 days and high-risk for progression who are admitted for reasons other than COVID-19 (see CDC Website for high-risk criteria)

Omadacycline

Oral formulation 

Restricted to ID or Antimicrobial Stewardship except:

1) Continuation of prior therapy

ZSFG: Non-formulary

Oritavancin

Restricted to ID or Antimicrobial Stewardship 

ZSFG: Non-formulary

Pentamidine IV

Restricted to ID or Antimicrobial Stewardship 

Peramivir

Restricted to ID or Antimicrobial Stewardship 

ZSFG: Non-formulary

Plazomicin

Restricted to ID or Antimicrobial Stewardship 

ZSFG: Non-formulary

Polymyxin B

Restricted to ID or Antimicrobial Stewardship 

ZSFG: Non-formulary

Posaconazole

IV formulation - Restriced to ID or Antimicrobial Stewardship except:

Inability to tolerate or absorb enteral medications and one of the following:​

1) Prophylaxis against fungal infections in patients on the hematology/BMT/lung/heart transplant services with an intolerance of or contraindications to voriconazole

2) Suspected or documented serious fungal infection in the hematology/BMT or lung transplant services

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

 

PO formulation - Restricted to ID or Antimicrobial Stewardship except:

1) Prophylaxis against fungal infections in patients on the hematology/BMT/lung/heart transplant services with an intolerance of or contraindications to voriconazole

2) Suspected or documented serious fungal infection in the hematology/BMT or lung transplant services

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

Sulbactam/durlobactam

Restricted to ID/ASP approval for CR-ABC infections

ZSFG: Non-formulary

Tedizolid

Restricted to ID or Antimicrobial Stewardship 

ZSFG: Non-formulary

Tigecycline

Restricted to ID or Antimicrobial Stewardship 

Voriconazole

Restricted to ID or Antimicrobial Stewardship except:

1) Prophylaxis against fungal infections on the hematology/BMT/lung/heart transplant services​

2) Suspected or documented serious fungal infection in the hematology/BMT/lung transplant services​

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

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