Levofloxacin injection — CareFirst (Caremark)

Initial criteria

• Patient age ≥ 18 years for most indications; ≥ 6 months for plague prophylaxis and pediatric use indicated
• Diagnosis of a listed infection due to susceptible microorganisms as specified
• Intravenous administration is clinically appropriate when patient cannot tolerate an oral dosage form
• Use only to treat or prevent infections proven or strongly suspected to be caused by susceptible bacteria