 |
|
|---|---|
| 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 |
| Tigecycline |
Restricted to ID or Antimicrobial Stewardship |
| Tedizolid |
Restricted to ID or Antimicrobial Stewardship ZSFG: Non-formulary |
| Sulbactam/durlobactam |
Restricted to ID or Antimicrobial Stewardship approval for CR-ABC infections 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
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 |
| Polymyxin B |
Restricted to ID or Antimicrobial Stewardship ZSFG: Non-formulary |
| Plazomicin |
Restricted to ID or Antimicrobial Stewardship ZSFG: Non-formulary |
| Peramivir |
Restricted to ID or Antimicrobial Stewardship ZSFG: Non-formulary |
| Pentamidine IV |
Restricted to ID or Antimicrobial Stewardship |
| Oritavancin |
Restricted to ID or Antimicrobial Stewardship ZSFG: Non-formulary |
| Omadacycline |
Oral formulation Restricted to ID or Antimicrobial Stewardship except: 1) Continuation of prior 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) |
| Miltefosine |
Restricted to ID or Antimicrobial Stewardship with exceptions: 1) Continuation of therapy ZSFG: Non-formulary |
| 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 |
| Meropenem/vaborbactam |
Restricted to ID or Antimicrobial Stewardship |
| Maribavir |
Restricted to ID or Antimicrobial Stewardship except: 1) Continuation of prior therapy ZSFG: Non-formulary |
| Letermovir |
Restricted to ID or Antimicrobial Stewardship except: 1) Adult malignant hematology service - for prophylaxis only per service guidelines ZSFG: Non-formulary |
| 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. |
| Imipenem/cilastatin/relebactam |
Restricted to ID or Antimicrobial Stewardship |
| Imipenem/cilastatin |
Restricted to ID or Antimicrobial Stewardship |