FormWeb • Restricted Antimicrobials

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Brand name products with an equivalent generic may not be available to order at Henry Ford Health. For questions, contact inpatient pharmacy.

Henry Ford Health

Approved Enterprise Formulary

FormWeb QuickStart Questions or Suggestions? Pharmacy Shared Services Center

Restricted Antimicrobials

Please review each of these drugs carefully.

amphotericin B liposomal	Criteria Monitored and Restricted Antimicrobials
anidulafungin	Criteria Monitored and Restricted Antimicrobials
artemether-lumefantrine	Criteria Monitored and Restricted Antimicrobials
artesunate	Criteria Monitored and Restricted Antimicrobials
avibactam-ceftazidime	Criteria Monitored and Restricted Antimicrobials
aztreonam	Criteria Monitored and Restricted Antimicrobials
aztreonam-avibactam	Criteria Monitored and Restricted Antimicrobials
cefepime	Criteria Monitored and Restricted Antimicrobials
cefiderocol	Criteria Monitored and Restricted Antimicrobials
ceftaroline	Criteria Monitored and Restricted Antimicrobials
cefTAZidime	Criteria Monitored and Restricted Antimicrobials
ceftolozane-tazobactam	Criteria Monitored and Restricted Antimicrobials
cidofovir	Criteria Monitored and Restricted Antimicrobials
ciprofloxacin	Criteria Monitored and Restricted Antimicrobials
colistimethate	Criteria Monitored and Restricted Antimicrobials
dalbavancin	Criteria Monitored and Restricted Antimicrobials
DAPTOmycin	Criteria Monitored and Restricted Antimicrobials
eravacycline	Criteria Monitored and Restricted Antimicrobials
ertapenem	Criteria Monitored and Restricted Antimicrobials
fidaxomicin	Criteria Monitored and Restricted Antimicrobials
flucytosine	Criteria Monitored and Restricted Antimicrobials
foscarnet	Criteria Monitored and Restricted Antimicrobials
fosfomycin	Criteria Monitored and Restricted Antimicrobials
imipenem-cilastatin	Criteria Monitored and Restricted Antimicrobials
isavuconazonium	Criteria Monitored and Restricted Antimicrobials
itraconazole	Criteria Monitored and Restricted Antimicrobials
ivermectin	Criteria Monitored and Restricted Antimicrobials
letermovir	Criteria Monitored and Restricted Antimicrobials
levoFLOXacin	Criteria Monitored and Restricted Antimicrobials
linezolid	Criteria Monitored and Restricted Antimicrobials
maribavir	Criteria Monitored and Restricted Antimicrobials
meropenem	Criteria Monitored and Restricted Antimicrobials
meropenem-vaborbactam	Criteria Monitored and Restricted Antimicrobials
minocycline	Criteria Monitored and Restricted Antimicrobials
moxifloxacin	Criteria Monitored and Restricted Antimicrobials
oritavancin	Criteria Monitored and Restricted Antimicrobials
pentamidine	Criteria Monitored and Restricted Antimicrobials
piperacillin-tazobactam	Criteria Monitored and Restricted Antimicrobials
polymyxin B sulfate	Criteria Monitored and Restricted Antimicrobials
posaconazole	Criteria Monitored and Restricted Antimicrobials
remdesivir	Criteria Monitored and Restricted Antimicrobials
rezafungin	Criteria Monitored and Restricted Antimicrobials
sofosbuvir-velpatasvir	Criteria Monitored and Restricted Antimicrobials
voriconazole	Criteria Monitored and Restricted Antimicrobials

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