PRIOR AUTHORIZATION PROTOCOLS

Transcription

1 PRIOR AUTHORIZATION PROTOCOLS How do I request an exception to the Gundersen Lutheran Health Plan s Formulary? You can ask Gundersen Lutheran Health Plan to make an exception to our coverage rules. There are several types of exceptions that you can ask us to make. You can ask us to cover your drug even if it is not on our formulary. You can ask us to waive coverage restrictions or limits on your drug. For example, for certain drugs, Gundersen Lutheran Health Plan limits the amount of the drug that we will cover. If your drug has a quantity limit, you can ask us to waive the limit and cover more. You can ask us to provide a higher level of coverage for your drug. If your drug is contained in our non-preferred tier, you can ask us to cover it at the cost-sharing amount that applies to drugs in the preferred tier instead. This would lower the amount you must pay for your drug. Please note, if we grant your request to cover a drug that is not on our formulary, you may not ask us to provide a higher level of coverage for the drug. Also, you may not ask us to provide a higher level of coverage for drugs that are in the specialty tier. Generally, Gundersen Lutheran Health Plan will only approve your request for an exception if the alternative drugs included on the plan s formulary, the lower-tiered drug or additional utilization restrictions would not be as effective in treating your condition and/or would cause you to have adverse medical effects. You should contact us to ask us for an initial coverage decision for a formulary, tiering or utilization restriction exception. When you are requesting a formulary, tiering or utilization restriction exception you should submit a statement from your physician supporting your request. Generally, we must make our decision within 72 hours of getting your prescribing physician s supporting statement. You can request an expedited (fast) exception if you or your doctor believe that your health could be seriously harmed by waiting up to 72 hours for a decision. If your request to expedite is granted, we must give you a decision no later than 24 hours after we get your prescribing physician s supporting statement. Your physician must submit a statement supporting your coverage determination or exception request. In order to help us make a decision more quickly, you should include supporting medical information from your doctor when you submit your exception request. What if I have additional questions? You can call us at: (seven days a week, 24 hours a day) if you have any additional questions. If you have a hearing or speech impairment, please call us at TTY

2 abelcet Aspergillosis, Blastomycosis, Candidiasis, Cryptococcal meningitis, Leishmaniasis and Systemic mycosis. **Note: THIS FORMULATION IS NOT INTERCHANGEABLE WITH OTHER FORMULATIONS, SUCH AS CONVENTIOL AMPHOTERICIN B, AMPHOTERICIN B CHOLESTERYL SULFATE COMPLEX, OR AMPHOTERICIN B LIPOSOME

3 actiq Breakthrough cancer pain in opioid tolerant patients with malignancies currently taking chronic pain medications

4 adagen Adagen' is indicated for enzyme replacement therapy for adenosine deaminase (ADA) deficiency in patients with severe combined immunodeficiency disease (SCID) who are not suitable candidates for or who have failed bone marrow transplantation. Adagen' is not intended as a replacement for HLA identical bone marrow transplant therapy ADAGEN' (pegademase bovine) Injection is recommended for use in infants from birth or in children of any age at the time of diagnosis. Pregnancy category C.

5 aldurazyme Mucopolysaccharidosis Type I Pregnancy Category: B--Patients should receive antipyretics and/or antihistamines prior to infusion Patient Must Be At Least 5 Years Of Age

6 aloxi Chemotherapy-induced nausea and vomiting - Prophylaxis, Postoperative nausea and vomiting - Prophylaxis. Patient must be at least 18 years old May be covered under Part D if it does not meet the coverage criteria under Part B.

7 anzemet Prevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy, including cisplatin -Greater Than- /=50 mg/m 2. Prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy. Prevention of nausea and vomiting associated with radiotherapy in patients receiving either total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen. Prevention of postoperative nausea and/or vomiting. As with other antiemetics, routine prophylaxis is not recommended for patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively Patients must be at least 2 years old This medication must not meet the criteria for coverage under Medicare Part B

8 aralast Alpha-1-antitrypsin deficiency Patients must be immunized against Hepatitis B prior to receiving Prolastin' Patient must be at least 12 years old.

9 arcalyst Covered indications include the treatment of cryopyrin-associated periodic syndromes (CAPS) including familial cold autoinflammatory syndrome (FCAS) and Muckle-Wells syndrome. Patient may not take Arcalyst while on etanercept, infliximab, adalimumab or anakinra. Patients must be greater than or equal to 12 years of age

10 arixtra Arthroplasty of knee, Total - Postoperative deep vein thrombosis - Prophylaxis. Deep venous thrombosis, acute, In conjunction with warfarin sodium. Postoperative deep vein thrombosis - Prophylaxis - Repair of hip. Postoperative deep vein thrombosis - Prophylaxis - Total replacement of hip. Pulmonary embolism, acute, In conjunction with warfarin sodium when initial therapy is administered in a hospital. Active major bleeding - risk of uncontrollable hemorrhage--bacterial endocarditis--body weight less than 50 kg for prophylactic therapy of hip fracture, hip replacement or knee replacement surgery, or abdominal surgery - increased risk for major bleeding episodes-- Fondaparinux-related thrombocytopenia--hypersensitivity to fondaparinux--severe renal impairment (creatinine clearance less than 30 milliliters/minute) - increased risk for major bleeding episodes Patient must be at least 18 years old

11 baraclude Active type B viral hepatitis, chronic LFTs must be monitored Patient must be at least 16 years old

12 barbiturate Patient has a verified diagnosis for the treatment of epilepsy, cancer, or a chronic mental health disorder.

13 beta-lactam, other Beta-lactam agents, other will be covered for: Endometritis (Azactam), Female genital infection (Azactam, Primaxin), Infection of skin and/or subcutaneous tissue (Azactam, Invanz, Merrem, Primaxin), Infection of abdomen (Azactam, Invanz, Merrem, Primaxin, Doribax), Lower respiratory tract infection (Azactam, Primaxin), Septicemia (Azactam, Primaxin), Urinary tract infection disease (Azactam, Invanz, Primaxin, Doribax), Community acquired pneumonia (Invanz), Diabetic foot infection, without osteomyelitis (Invanz), Operation of intestine, Prophylaxis or postoperative wound infection (Invanz), Pelvic Infection, acute (Invanz), Bacterial meningitis (Merrem), Bacterial endocarditis (Primaxin), Infection of bone'infectious disorder of the joint (Primaxin), Polynephritis (Doribax), Primaxin - UTI and polymicrobic infections. Invanz, Community Acquired Pneumonia, Dorbiax, complicated UTI.

14 carbaglu Covered indications include the treatment of hyperammonemia in patients with N-acetylglutamate synthase deficiency both as an adjunctive therapy for the treatment of acute hyperammonemia and as maintenance therapy for chronic hyperammonemia. Obtain baseline ammonia levels prior to treatment initiation. Lab values or chart notes confirming deficiency of the hepatic enzyme N- acetylglutamate synthase. Medication must be prescribed by a endocrinologist or other prescriber with experience in N-acetylglutamate synthase deficiency.

15 cayston Covered indications include to improve respiratory symptoms in cystic fibrosis patients with Pseudomonas aeruginosa. Documentation must be provided with evidence of Pseudomonas aeruginosa lung infection. Patients must be at least 7 years of age. Medication is being prescribed by a pulmonologist or endocrinologist.

16 cerezyme Non-neuropathic Gaucher's disease, chronic

17 degarelix Advanced prostate cancer (Stage T3 or T4).

18 dificid Covered indications include the treatment of pseudomembranous colitis or Clostridium difficile-associated diarrhea (CDAD). Patients must documented failures to metronidazole. Patients must be greater than or equal to 18 years of age. Medication must be prescribed by a gastroenterologist or infectious disease specialist.

19 enbrel Psoriatic arthritis. Rheumatoid arthritis (RA). Juvenile rheumatoid arthritis (JRA). Ankylosing spondylitis (AS), Adult plaque psoriasis, as defined by the American College of Rheumatology (ACR). shall not be granted for use Wegener's granulomatosis. patient with a diagnosis of plaque psoriasis must have had an inadequate response or a documented failure due to lack of efficacy to one or more of the following, Topical corticosteroid, Tazarotene, Anthralin. Patient with a diagnosis of either rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis or psoriatic arthritis must have had an inadequate response or a documented failure due to lack of efficacy to one or more of the following disease modifying antirheumatic drugs (DMARDs), Methotrexate, Hydroxychloroquine, D-penicillamine, Sulfasalazine, Leflunomide, Azathioprine, Oral/Injectable Gold Compounds.

20 exjade 1. Chronic iron toxicity. 2. Chronic iron toxicity secondary to transfusional iron overload. Exjade will NOT be covered for a diagnosis of hemochromatosis or when phlebotomy is an appropriate treatment

21 fabrazyme Fabry's disease Patient must be at least 8 years old

22 forteo Postmenopausal osteoporosis in women who are at a high risk for fracture, Primary osteoporosis in men, Hypogondal osteoporosis in men, glucocorticoid-induced osteoporosis in patients at high risk of fracture. Forteo shall not be approved for any of the following reasons: in children or adolescents, Paget's disease of the bone, hypercalcemia, patients with bone cancer or other cancers that have metastasized to the bones The patient should also meet National Osteoporosis Foundation guidelines for treatment and have one of the following: 1. Bone Mineral Density (BMD) 2.5 or more standard deviations below the mean value (ie T-score less than 2.5) with no risk factors OR 2. BMD T-score below 1.5 (1.5 or more standard deviations below the mean value) with one or more risk factors 3. Prior vertebral or hip fracture 4. Patients must also have a prior failure or intolerance to at least one of the following therapies: Bisphosphonate (Fosamax, Actonel, Boniva), Miacalcin, Evista (SERM)

23 fungizone FUNGIZONE INTRAVENOUS (Amphotericin B for injection) will be covered for: Patient has a potentially life-threatening fungal infection such as one of the following: ASPERGILLOSIS, BLASTOMYCOSIS, SYSTEMIC CANDIDIASIS, COCCIDIOIDOMYCOSIS, CRYPTOCOCCOSIS, HISTOPLASMOSIS, ZYGOMYCOSIS, LEISHMANIASIS, SPOROTRICHOSIS Fungizone Intravenous should not be used to treat noninvasive fungal infections such as oral thrush, vaginal candidiasis, and esophageal candidiasis in patients with normal neutrophil counts This medication does not meet coverage criteria under Medicare Part B

24 immunizing agents, passive

25 kuvan Covered indications include the treatment of hyperphenylalaninemia (HPA) due to tetrahydrobiopterin (BH4)-responsive phenylketonuria (PKU) in conjunction with a phenylalanine (Phe)-restricted diet. 1) A baseline phenylalanine level must be obtained prior to treatment initiation. Patients must be greater than or equal to 4 years of age.

26 kytril Prophylaxis of Chemotherapy-Induced Nausea and Vomiting, Postoperative nausea and vomiting, Posoperative nausea and vomiting - prophylaxis, Radiation - induced nausea and vomiting - prophylaxis. Patient must be at least 2 years old.

27 letairis Available only through the Letairis Education Access Program (LEAP) by calling LEAP (5327) or by logging on to Pulmonary hypertensive arterial disease, WHO functional class II or III Safety and effectiveness not established in pediatric patients

28 leukine Acute myeloid leukemia, Following chemotherapy. Bone marrow transplant, Myeloid reconstitution. Bone marrow transplant failure - Graft acceptance. Peripheral blood stem cell harvest, Mobilization, Febrile Neutropenia. Concomitant chemo- or radiotherapy (or within 24 hours before or after). Excess leukemic myeloid blasts in the blood/bone marrow (greater than10%). Hypersensitivity to GM-CSF or yeast-derived products Patient must have biweekly CBC with differential Patient must be at least 18 years old.

29 lupron, eligard Breast cancer, Endometriosis (Lupron Depot 3 month mg q 3 months, or Lupron Depot 3.75 mg q month). Leiomyomata uteri (Uterine Fibroids) for preoperative hematological improvement in patients with anemia caused by the uterine leiomyomata (Lupron Depot 3 month mg or Lupron Depot 3.75 mg q month X 3). Precocious Puberty in children (-Less Than-25 kg=lupron Depo Ped 7.5 mg q month - -Greater Than-25kg-37.5 kg=lupron Depot Ped mg q month - -Greater Than-37.5 kg=lupron Depo Ped 15 mg q month). Prostate Cancer (Lupron Depot 3 month 22.5 mg q 84 days - Lupron Depot 4 month 30 mg q 16 weeks - Lupron Depot 7.5 mg q month, Viadur' implant inserted into inner area of upper arm SC q12months) For patients with precocious puberty, they must meet the following criteria: Have a diagnosis of central precocious puberty (idiopathic or neurogenic) Have an onset of secondary sexual characteristics earlier than 8 years in females and 9 years in males. Have diagnosis confirmed by a pubertal response to a GnRH stimulation test. Have bone aged advanced one year beyond the chronological age. Complete baseline evaluations for sex steroid levels.

30 mepron Pneumocystis pneumonia - prophylaxis, Pneumocystis pneumonia, Babesiosis, Malaria, Toxoplasmosis. Patient with a diagnosis of pneumocystis pneumonia must have a documented allergy or intolerance to Sulfamethoxazole- Trimethoprim. Patient needing prophylaxis for pneumocystis pneumonia must have a documented failure, allergy, or intolerance to one of more of the following, Sulfamethoxazole-Trimethoprim, Dapsone, Aerosolized pentamidine.

31 mesnex Medication is being used for the prevention of hemorrhagic cystitis due to ifosfamide or cyclophosphamide therapy This medication does not meet coverage criteria under Medicare Part B.

32 myozyme Glycogen storage disease, type II Caution must be used because of the potential for severe infusion reactions - appropriate medical support measures should be readily available when alglucosidase alfa is administered.

33 naglazyme Maroteaux-Lamy syndrome Safety and efficacy in patients younger than 5 years of age have not been evaluated.

34 neumega Prevention of severe thrombocytopenia and the reduction of the need for platelet transfusions following myelosuppressive therapy in a dult patients at high risk of severe thrombocytopenia. Baseline and periodic CBC. Platelet counts at the time of expected nadir and until post-nadir counts are greater than or equal to 50,000/microliter. Safety and efficacy not established in pediatric patients - doselimiting papilledema has occurred

35 neupogen Neutropenia secondary to chemotherapy--bone marrow transplantation--idiopathic, cyclic, or congenital neutropenia, Peripheral blood progenitor cell (PBPC) mobilization or Post-PBPC transplantation, AIDS-associated neutropenia, Drug-induced neutropenia, Myelodysplastic syndromes complicated with infection Prior authorizations will only be approved for patients who will be self-administering filgrastim. Patients that receive their injections in the provider's office or from home health care should have the filgrastim covered under their medical benefit. Appropriate lab tests - CBC and platelet count, must be conducted to necessitate the continuation of therapy.

36 pentam Pneumocystis carinii pneumonia. Pneumocystis carinii pneumonia, high-risk, HIV patients - prophylaxis Pregnancy category C. Contraindications: hypersensitivity to pentamidine or diamidine compounds. Monitoring of the following is necessary prior to and during treatment: CBC, platelet counts, serum calcium concentrations, hepatic function, and ECG. Daily BUN, serum creatinine, and blood glucose levels

37 prolia Covered indications include postmenopausal osteoporosis in women with high fracture risk, the prevention of skeletal-related events in patients with bone metastases from solid tumors, osteoporosis prophylaxis in men at high risk for bone fractures after receiving androgen deprivation therapy for nonmetastatic prostate cancer and in women at high risk for bone fractures after receiving adjuvant aromatase inhibitor therapy for breast cancer. 1) Patients with hypocalcemia. 1) When using Prolia for osteoporosis in men and women at high risk for bones fractures with nonmetastatic prostate cancer or breast cancer, must provide evidence that men have been receiving androgen deprivation therapy (surgical castration or medical castration with GnRH agonist, GnRH antagonists, or antiandrogens) and women have been receiving adjuvant aromatase inhibitor therapy. 2) When using Prolia for postmenopausal osteoporosis in women with high fracture risk, patient must meet criteria for having high fracture risk including one of the followinghistory of osteoporotic fracture, family history of fracture, low body mass index, rheumatoid arthritis, use of corticosteroids, anticonvulsants, or loop diuretics, increased fall risk (poor vision, dementia, neuromuscular disorder), low bone mineral density with a T-score of -2.5 or lower, age greater than or equal to 50 years of age, current smoker, or alcohol intake greater than or equal to 3 drinks per day. 3) A baseline calcium level must be obtained prior to treatment initiation. Patients must be greater than or equal to 18 years of age.

38 promacta Covered indicationsn include the treatment of thrombocytopenia in patients with chronic idiopathic thrombocytopenic purpura (ITP) who have had an insufficient response to corticosteroids, immunoglobulins, or splenectomy. 1) Patients must have a documented past failure or intolerance to one of the following - corticosteroids, immunoglobulins, or a splenectomy. 2) Baseline liver function tests and a complete blood count should be obtained prior to treatment initiation. Patients must be greater than or equal to 18 years of age.

39 pulmozyme Covered indications include the management of cystic fibrosis in conjunction with standard therapies, to improve pulmonary function. Patients must be greater than or equal to 5 years of age.

40 relistor Covered indications include the treatment of opiate agonist-induced constipation in patients with advanced illness who are receiving palliative care when response to laxative therapy has been insufficient. 1) Patient is receiving opioids. 2)Patient has an advanced illness and receiving palliative care. 3) Patient has failed or has an intolerance to other conventional laxative therapy. Patients must be greater than or equal to 18 years of age.

41 sandostatin lar depot, sandostatin inj. Acromegaly, Carcinoid tumors, Vasoactive Intestinal Peptide Tumors (VIPomas). The patient must tolerate an initial treatment of Sandostatin' Injectable for a minimum of 2 weeks. The patient must be at least 18 years old.

42 simponi Rheumatoid arthritis in combination with methotrexate, psoriatic arthritis alone or in combination with methotrexate, and ankylosing spondylitis. Patient must be 18 years of age or older.

43 somatuline Covered indications include the long-term treatment of acromegaly in patients who have had an inadequate response to surgery and or radiotherapy, or for whom surgery and or radiotherapy is not an option. 1) A baseline growth hormone level must be obtained prior to treatment initiation. Patients must be greater than or equal to 18 years of age. Medication must be prescribed by an endocrinologist.

44 synarel Central Precocious Puberty In Children of Both Sexes, Endometriosis Patient must not be pregnant (cat. X) Patient must be at least 18 years old for diagnosis of endometriosis.

45 tobi Indication for the management of cystic fibrosis patients with Pseudomonas Aeruginosa. Patient must not be pregnant. (CATEGORY 'D'). Patient must be 6 years of age or older.

46 tygacil COVERED USES: All FDA-Approved indications not otherwise excluded from Part D. A complicated skin infection by one of the following: E. coli, Enterococcus faeclis (vancomycin-susceptible only), Staphylococcus aureus (methicillin-susceptible and methicillinresistant), Streptococcus agalactiae, Streptococcus anginosus (including S. anginosus, S. intermedius, and S. contellatus), Streptococcus pyogenes and Bacteroidesfragilis. A complicated intra-abdominal infection as a result from one of the following: Citrobacter freundii, Enterobacter cloacae, E. coli, Klebsiella oxytoca, Klebsiella pneumoniae, Enterococcus faecalis (vancomycinsusceptible only), Staphylococcus aureus (methicillin-susceptible only), Streptococcus anginosus (including S. anginosus, S. intermedius, and S. constellatus), Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides uniformis, Bacteroides vulgatus, Clostrdium perfringens, and Peptostreptococcus micros. If the patient has severe hepatic impairment (Child Pugh C), an initial dose of 100 mg of Tygacil' should be given followed by a maintenance dose of 25 mg every 12 hours. The patient should be closely monitored for treatment response. The patient must be at least 18 years old

47 tysabri Relapsing Multiple Sclerosis, Crohn's Disease. Pregnancy Category: C. Patient Must Be At Least 18 Years Old. Marketing of the drug was voluntarily suspended in March However, the clinical hold on natalizumab was lifted under specific circumstances on February 15, Natalizumab may be resumed in patients who had previously been receiving the drug within an investigational new drug (IND) study. Tysabri is available only through a special restricted distribution program called the TOUCH Prescribing Program and must be administered only to patients enrolled in this program.

48 vancocin Covered indications include the treatment of pseudomembranous colitis due to Clostridium difficile and the treatment of enterocolitis due to Staphylococcus aureus. Must obtain stool culture report within the previous 30 days indicating positive C. difficile toxin.

49 vfend Aspergillosis, Invasive, Candidemia, Candidiasis of the esophagus, Disseminated candidiasis, of the skin and infections in abdomen, kidney, bladder wall, and wounds, Mycosis, Serious infections due to Scedosporium apiospermum and Fusarium species. Patient must be at least 12 years old.

50 vivitrol Alcohol dependence, maintenance of abstinence Patients must not have acute hepatitis or liver failure. Patient must not have an opioid dependency or acute opiate withdrawal. Patient must not be taking opioid analgesics as concomitant therapy Patients must be at least 18 years old

51 xenazine Covered indications include the treatment of chorea associated with Huntington's Disease (Huntington's Chorea). Patients with hepatic impairment. Baseline liver function tests should be obtained prior to treatment initiation. Patients must be greater than or equal to 18 years of age.

52 xeomin Covered indications include the treatment of blepharospasm in patients who were previously treated with onabotulinumtoxina (Botox) and the treatment of cervical dystonia to decrease the severity of abnormal head position and neck pain in both botulinum toxin-naive and botulinum toxin-experienced patients. Cosmetic use of Xeomin for facial wrinkles. Patient must be greater than or equal to 18 years of age.

53 xyrem Cataplexy associated with narcolepsy The patient is not concurrently taking any sedative hypnotic agents at the time of the prior authorization review Patient must be at least 16 years old.

54 zofran Prevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy, including cisplatin -Greater Than- /=50 mg/m 2. Prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy. Prevention of nausea and vomiting associated with radiotherapy in patients receiving total body irradiation, single highdose fraction to the abdomen, or daily fractions to the abdomen. Prevention of postoperative nausea and/or vomiting. As with other antiemetics, routine prophylaxis is not recommended for patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively. In patients where nausea and/or vomiting must be avoided postoperatively, ZOFRAN Tablets, ZOFRAN ODT Orally Disintegrating Tablets, and ZOFRAN Oral Solution are recommended even where the incidence of postoperative nausea and/or vomiting is low. Patients must by over the age of 2 years old.

55 zorbtive Cachexia associated with AIDS, Growth hormone deficiency, Short Bowel Syndrome

56 zosyn Appendicitis, Complicated by rupture or abscess, Community acquired pneumonia, Infection of skin and subcutaneous tissue, including diabetic foot infections, Nosocomial pneumonia, Pelvic inflammatory disease, Peritonitis, Puerperal endometritis. Zosyn is contraindicated in patients with a history of allergic reactions to any of the penicillins, cephalosporins, or (beta)- lactamase inhibitors. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Zosyn (piperacillin and tazobactam) injection and other antibacterial drugs, Zosyn (piperacillin and tazobactam) 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.

57 zuplenz Covered indications include treatment for chemotherapy-induced nausea or vomiting prophylaxis associated with moderately and highly emetogenic cancer chemotherapy, postoperative nausea or vomiting prophylaxis, and radiotherapy-induced nausea or vomiting prophylaxis. Zuplenz will not be approved to be used on an as needed basis. Patient must be unable to tolerate oral ondansetron. Patients must be greater than or equal to 2 years of age.

58 zyclara Covered indications include the treatment of external genital and perianal warts -condylomata acuminata due to human papillomavirus and the treatment of actinic keratosis. Zyclara will not be approved for treating superficial basal cell carcinomas. When treating actinic keratosis, leasions should be located on the face or scalp. When treating actinic keratoses, patients must be greater than or equal to 18 years of age. When treating condylomata acuminata, patients must be greater than or equal to 12 years of age.

59 zyvox Patient has Vancomycin-resistant Enterococcus faceium infection including patients with concurrent bacteremia. Patient has nosocomial pneumonia caused by Staphylococcus aureus (methicillin-resistant or methicillin-sensitive strains) or Streptococcus pneumoniae (including multi-drug resistant strains: ie penicillin, second-generation cephalosporins, macrolides, tetracycline, and trimethoprim/sulfamethoxazole.) Patient has a complicated skin and skin structure infection caused by Staphylococcus aureus (methicillin-resistant or methicillin-sensitive strains), Streptococcus pyogenes, or streptococcus agalactiae (including diabetic foot infections without concomitant osteomyelitis). Patient requires a weekly CBC.