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ZyvoxCareFirst (Caremark)

Vancomycin-resistant Enterococcus faecium infections

Initial criteria

  • The patient has ANY of the following:
  • • An infection caused by vancomycin-resistant Enterococcus faecium including cases with concurrent bacteremia.
  • • A nosocomial (institution-acquired) pneumonia caused by Staphylococcus aureus (methicillin-susceptible and -resistant isolates) or Streptococcus pneumoniae.
  • • Community-acquired pneumonia caused by Streptococcus pneumoniae, including cases with concurrent bacteremia, or Staphylococcus aureus (methicillin-susceptible isolates only).
  • • A complicated skin and skin structure infection including diabetic foot infections, without concomitant osteomyelitis, caused by Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus pyogenes, or Streptococcus agalactiae.
  • • An uncomplicated skin and skin structure infection caused by Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes.
  • The infection is proven or strongly suspected to be caused by susceptible bacteria.
  • The patient will use the requested drug orally or intravenously.

Approval duration

28 days