Orbactiv (oritavancin) — CareFirst (Caremark)

Initial criteria

• Patient is an adult
• Infection is caused by susceptible isolates of one of the following Gram-positive microorganisms: Staphylococcus aureus (including methicillin-susceptible and methicillin-resistant isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group (includes S. anginosus, S. intermedius, and S. constellatus), or Enterococcus faecalis (vancomycin-susceptible isolates only)
• Orbactiv should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria
• When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy
• In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy