Pharmacy Prior Authorization Criteria

Aemcolo (rifamycin)

For diagnosis of Travelers' Diarrhea (TD)
Indicated for the treatment of travelers’ diarrhea (TD) caused by noninvasive strains of Escherichia coli in adults.
Limitations of use: Aemcolo is not indicated in patients with diarrhea complicated by fever or bloody stool or due to pathogens other than noninvasive strains of Escherichia coli. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Aemcolo and other antibacterial drugs, Aemcolo should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

Prior Authorization

Length of Approval: 14 days [A]

AND

AND

Resistance, contraindication, or intolerance to all of the following antibiotics:

2023-12-29, 2023-01-31, 2022-01-27, 2021-02-03, 2020-01-22

Aemcolo prescribing information. Cosmo Technologies, Ltd. San Diego, CA. February 2021.
Riddle MS, Connor BA, Beeching NJ, et al. Guidelines for the prevention and treatment of travelers’ diarrhea: a graded expert panel report. J Travel Med. 2017;24(suppl 1):S63-S80.
Connors BA. Travelers’ diarrhea: CDC Health Information for International Travel. Centers for Disease Control and Prevention; 2020. Available at: https://wwwnc.cdc.gov/travel/yellowbook/2020/preparing-international-travelers/travelers-diarrhea. Accessed December 29, 2023.

The recommended dosage of Aemcolo is 388 mg (two tablets) orally twice daily for three days. 14 day approval length allows for sufficient time for the patient to pick up the medication from the pharmacy. [1]
For those who present with uncomplicated travelers' diarrhea (TD), determination of the microbiologic agent is generally unnecessary, but when culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. Aemcolo was not shown to be effective in patients with diarrhea complicated by fever and/or bloody stool. The effectiveness of Aemcolo in TD caused by pathogens other than E. coli has not been demonstrated. [1, 2]
According to the Centers for Disease Control and Prevention's Yellow Book, fluoroquinolones including, but not limited to, ciprofloxacin and levofloxacin, are considered first line agents in the treatment of TD. Azithromycin is also considered a first line agent for treatment of TD and is especially efficacious in the pediatric population. [2, 3]