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36.4.20.2 Alatrofloxacin Mesylate (Trovan)
The Texas Medicaid Program follows the recommendation of the FDA about the use of intravenous alatrofloxacin mesylate, (Trovan). Alatrofloxacin mesylate is not reimbursed when provided in settings other than inpatient hospital. Alatrofloxacin mesylate should be reserved for use only in the treatment of patients who meet all the following treatment criteria:
• Have at least one of the following infections judged by the treating physician to be serious and life- or limb-threatening:
•Nosocomial pneumonia.
•Community-acquired pneumonia.
•Complicated intra-abdominal infections (including postsurgical infections).
•Gynecologic and pelvic infections.
•Complicated skin and skin-structure infections (including diabetic foot infections).
•Receive initial therapy in an inpatient health-care facility.
•The treating physician believes that, given the new safety information, the benefit of the product to the patient outweighs the risk.
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