Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

APPENDIX I: Infectious Diseases Approval of Restricted AntimicrobialsPURPOSE: To describe a mechanism for obtaining Infectious Diseases Section Approval oforders for restricted antimicrobials.POLICY:Designated physicians from the Infectious Diseases Section will review forapproval all orders for restricted antimicrobials. The designated physician will becontacted via a centralized paging system.PROCEDURE:1.0 The Pharmacy and Therapeutics Committee will determine which antimicrobial agentsrequire Infectious Diseases approval before dispensing.2.0 The Department of Pharmacy will maintain a list of current restricted antimicrobials as partof the UWHC formulary.3.0 The Infectious Diseases Section will designate a physician or physicians to be responsiblefor the approval of restricted antimicrobials.4.0 A designated physician will be contacted whenever an order for a restricted antimicrobial iswritten.4.1 When the order for the restricted antimicrobial is written, the pharmacist will informthe ordering, covering or attending physician of the existence of this policy(Pharmacy Policy #13.19) and that Infectious Diseases approval is required beforethe drug can be dispensed.4.1.1 If a patient is admitted on a restricted antimicrobial, Infectious Diseasesapproval is still required unless previous ID approval for the specific drughas been obtained for the current course of therapy.4.2 Between the hours of 0700 and 2300, the ordering physician or his/her physiciandesignee will contact either the Infectious Diseases designated physician via pager#3333. The Infectious Diseases Fellow may be contacted as a backup for approvalat his or her assigned pager if there is no response at the #3333 pager.4.3 The ordering physician will provide information to the Infectious Diseasesdesignated physician including patient MR#, unit, clinical condition and clinicalrationale for the use of the restricted antimicrobial.4.4 If the request is made between 2300 and 0700, or if a delay in approval of greaterthan one hour is anticipated, the pharmacy may dispense a single dose of therestricted antimicrobial. However, Infectious Diseases approval is required beforeany subsequent doses may be dispensed.4.5 The Infectious Diseases designated physician will discuss the appropriateness ofthe request with the ordering physician or designee and make a decision onwhether or not to approve the order. The prescribing physician will notify the unitpharmacist when approval is given and inform the pharmacist of the name of thephysician who gave the approval. The unit pharmacist will contact the InfectiousDiseases designated physician to verify that approval has been given.4.5.1 If the attending physician and the designated Infectious Diseasephysician do not agree, a single dose of the drug may be dispensed untila formal or informal ID consultation is obtained. A second ID staffphysician may serve as an arbitrator for the case.