FormWeb • Restricted Antimicrobials

Henry Ford Health

Approved Hospital Formulary

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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 Hospital Formulary

FormWeb QuickStart Questions or Suggestions? Pharmacy Intranet

Restricted Antimicrobials

Please review each of these drugs carefully.

acyclovir	Criteria Monitored Antimicrobials
amphotericin B	Restricted Antimicrobials - Intravenous
amphotericin B liposomal	Restricted Antimicrobials - Intravenous
ampicillin-sulbactam	Criteria Monitored Antimicrobials
anidulafungin	Restricted Antimicrobials Criteria Monitored Antimicrobials
artesunate	Restricted Antimicrobials
avibactam-ceftazidime	Restricted Antimicrobials
aztreonam	Criteria Monitored Antimicrobials
bezlotoxumab	Restricted Antimicrobials
cefepime	Criteria Monitored Antimicrobials
cefiderocol	Restricted Antimicrobial
ceftaroline	Criteria Monitored Antimicrobials
cefTAZidime	Tier 1: Restricted Antimicrobials
ceftolozane-tazobactam	Restricted Antimicrobials
cidofovir	Restricted Antimicrobials
ciprofloxacin	Criteria Monitored Antimicrobials
colistimethate	Restricted Antimicrobials - Inhaled Restricted Antimicrobials - Intravenous
DAPTOmycin	Restricted Antimicrobials
eravacycline	Restricted Antimicrobials
ertapenem	Restricted Antimicrobials Criteria Monitored Antimicrobials
fidaxomicin	Criteria Monitored Antimicrobials
imipenem-cilastatin	Restricted Antimicrobials
isavuconazonium	Restricted Antimicrobials
itraconazole	Restricted Antimicrobials
letermovir	Criteria Monitored Antimicrobials
linezolid	Restricted Antimicrobials Criteria Monitored Antimicrobials
meropenem	Restricted Antimicrobials
meropenem-vaborbactam	Restricted Antimicrobials
minocycline	Criteria Monitored Antimicrobials - Intravenous
moxifloxacin	Criteria Monitored Antimicrobials
pentamidine	Restricted Antimicrobials - Intravenous
piperacillin-tazobactam	Criteria Monitored Antimicrobials
polymyxin B sulfate	Restricted Antimicrobials - Intravenous
posaconazole	Restricted Antimicrobials
remdesivir	Criteria Monitored Antimicrobials
rezafungin	Restricted Antimicrobials
voriconazole	Criteria Monitored Antimicrobials

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