Antibacterial Drugs

This policy covers the lipoglycopeptides oritavancin, dalbavancin, telavancin and the oxazolidinone tedizolid for treatment of adult (>=18 years) Gram-positive skin and skin structure infections (ABSSSI; telavancin also for cSSSI and HABP/VABP due to S. aureus) when infections are caused by susceptible organisms. Enterococcus faecalis is eligible only if vancomycin-susceptible; use is limited to infections proven or strongly suspected to be caused by susceptible bacteria. Specific dosing regimens, routes, infusion durations, and treatment durations are specified for each agent and must be documented in the medical record with microbiology results or justification of strong clinical suspicion when cultures are unavailable.

"Oritavancin (Orbactiv) is indicated for treatment of acute bacterial skin and skin structure infections (ABSSSI) in adults (age >=18) caused by susceptible Gram-positive organisms including Staphyl..."