Xepi (ozenoxacin) — CareFirst (Caremark)
Topical treatment of impetigo due to Staphylococcus aureus or Streptococcus pyogenes
Initial criteria
- Patient has diagnosis of impetigo due to Staphylococcus aureus or Streptococcus pyogenes
- Patient age ≥ 2 months
- Requested drug is not being used in a footbath
Approval duration
1 month