Page 8 - Parkview Antimicrobial Stewardship Guidebook_Neat

Restricted Antimicrobials

Tier 1: limited to I.D only
Drug: Comments and/or Indication:
Telavancin (Vibativ) MRSA with complicated HCAP or SSTI
Colistin Resistant Pseudomonas
Chloramphenicol Cystic fibrosis or Meningitis
Ceftolazone/tazobactam (Zerbaxa) Meropenem resistant pseudomonas
Isavuconazole Invasive aspergiollosis or invasive mucormycosis
Fidoxomycin (GI is an exception) C. difficile

Tier 2: after 24 hours must have I.D consult
Drug: Comments and/or Indication:
Aminoglycosides OBGYN is an exception
Voriconazole • IV only on restriction, ok to continue oral
home med
• Labs must be sent out and take several days
for results
Amphotericin B Both conventional and liposomal (Ambisome)
Flucystosine Systemic fungal infections caused by Candida or
Cryptococcus

Tier 3: Culture and Sensitivity driven “48 hour rule”
Drug: Comments and/or Indication:
Meropenem Reserved for MDR bugs
Ertapenem (Ivanz) Reserved for MDR bugs. No pseudomonas coverage
Daptomycin (Cubicin) Gram positive blood stream infections and SSTI
Cerftaroline (Teflaro) MRSA cellulitis- too broad spectrum for cellulitis