Levofloxacin injection — CareFirst (Caremark)
Complicated skin and skin structure infections
Initial criteria
- Patient age ≥ 18 years unless otherwise specified for prophylaxis indications (e.g., plague ≥ 6 months of age).
- Use when intravenous administration offers a route advantageous to the patient (e.g., patient cannot tolerate oral dosage form).
- Infection must be proven or strongly suspected to be caused by susceptible bacteria listed for each indication.
- For nosocomial pneumonia where Pseudomonas aeruginosa is suspected or documented, combination therapy with an anti-pseudomonal β-lactam is recommended.
- For inhalational anthrax post-exposure, therapy duration should not exceed 28 days unless benefit outweighs risk.
- For prophylaxis of plague, use as indicated in adults and pediatric patients ≥ 6 months of age.
Reauthorization criteria
- Continued therapy may be approved if patient demonstrates clinical improvement and ongoing need for intravenous form of levofloxacin injection.