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Anti-Infective Formulary Management Guideline changed

21 Nov 2021

Removing barriers from verbal orders, curbside consults

By: Danielle Britt, MA, PharmD and Jasmin Chaudhary, MD

The following changes were made to the Anti-infective Formulary Management Guideline (Restricted Formulary) starting Nov. 5:

  • Removal of the verbal order option for non-ID providers trying to obtain:
    • Daptomycin
    • Ertapenem
    • Eravacycline
    • Fosfomycin
  • Approval for emergency room providers to place one-time orders of the previously listed agents any time of day for patients NOT admitted to the hospital.

WHY? Currently there are significant knowledge gaps with specific restricted formulary processes that may lead to inadequate medication therapy. Specifically, the verbal ordering process and curbside consults are creating obstacles for drug obtainment, confusion on appropriate use, and contributing to provider-provider miscommunication. This process needs further review and discussion to create a more efficient workflow for drug use.

HOW? When a provider orders a restricted agent, the pharmacist will review the ordering provider and indication selected for the medication. If an antimicrobial is not ordered by an ID provider or a provider does not choose one of the prelisted indications, the pharmacist verifying the order will notify provider. When giving feedback to the providers, pharmacists will be able to let the provider know what the correct ordering process is and provide indication suggestions or therapy alternatives if needed.

All other processes previously described in the restricted formulary remain the same.

A tip sheet with screenshots for this process as well as the most updated version of our restricted formulary is available on the Pharmacy page located on the hospital intranet under Departments. (You will need to be logged into the intranet to access the tipsheet.)

Please reach out with any question or concerns to Danielle Britt, MA, PharmD, Antimicrobial Stewardship/Infectious Diseases Pharmacist, 503-814-9981; or Jasmin Chaudhary, MD, Medical Director/Infection Prevention, 503-814-9981.