Rational Drug Therapy Program  WVBMS Drug Therapy Guidelines  Home IV Therapy    Home IV Form

All Home IV therapy will require prior approval.

Criteria requires that if the patient is currently taking other oral medications, justification will be needed as to why the patient cannot take oral medications. With the current broad spectrum, highly bioavailable agents there should be few Home IV antibiotic therapy needs.

Examples of drug classifications considered equally effective orally as to IV therapy:

1. Fluoroquinolone
2. Fluconazole
3. Penicillin's/Cephalosporins
4. Metronidazole

 

For Home IV Therapy the following information will be required:

A. Drug dosage and length of time

B. Diagnosis

C. Cultures and sensitivities

 

For Home IV Pain Therapy the following information will be required:

A. Drug dosage and length of therapy

B. Diagnosis

C. Assessment of concurrent oral pain therapies

 

For Home IV Chemo Therapy the following information will be required:

A. Drug dosage and length of time

B. Diagnosis

 

For Home IV Hydration Therapy the following information will be required:

A. Clinical justification for therapy exceeding 72 hours.

 

Specialty therapies will be reviewed on an individual basis.

Rational Drug Therapy Program  West Virginia University School of Pharmacy  P.O. Box 9511  Morgantown, WV 26506-9511  Phone 800 847 3859  Fax 800 531 7787