General Information

  • Complicated urinary tract infections, including pyelonephritis
  • MDRO enteric pathogens

Tier 4 Protected Antimicrobial

  • May be ordered by an ID physician for the defined use-criteria, if specified. If a non-ID prescriber orders a restricted antimicrobial, Pharmacy will contact the prescriber to notify him or her of this status and to select an alternative antimicrobial. If the restricted antimicrobial is necessary or is a continuation of a home medication, the prescriber must place a consult for an ID specialist to assess the necessity of this antimicrobial. Once the consult has been placed, Pharmacy will dispense the medication. These agents will be monitored by the ASP/Pharmacy and utilization/compliance reported quarterly.

Non-Formulary Antimicrobial

  • Requires approval from Antimicrobial Stewardship Subcommittee Chairpersons, regardless of inpatient or outpatient status. These medications are not stocked in the Pharmacy and require 24-48 hours for approval and procurement of the drug.
  • Monitor for signs of hypersensitivity reaction, including anaphylaxis and serious skin reactions.
  • Periodically monitor renal function; in patients with changing renal function, monitor serum creatinine and eGFR at least daily.

Headache, phlebitis, and diarrhea

  • Valproic acid: May decrease valproic acid concentrations, increasing risk of breakthrough seizures
  • Probenecid: increased concentrations of meropenem-vaborbactam
  • Meropenem: disrupts bacterial cell wall synthesis by inhibiting PBPs
  • Vaborbactam: boronic acid beta-lactamase inhibitor with no antibacterial activity alone