Issue: June 2013
May 23, 2013
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TB programs affected by isoniazid shortage

Issue: June 2013
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A shortage of isoniazid interfered with patient care and may contribute to the spread of tuberculosis in the United States, according to a report by the CDC.

“Interruptions in the supply of second-line anti-TB medications have been ongoing in the United States for several years,” the researchers wrote in Morbidity and Mortality Weekly Report. “But since November 2012, TB control programs have experienced the first sustained generalized supply interruption of a first-line anti-TB medication.”

According to the report, a shortage of 300 mg isoniazid tablets was first reported in November, which was attributed to difficulty procuring the active ingredient. In December, isoniazid became available in 100 mg tablets. Suppliers anticipated that the 300-mg tablets would be available by January, but they still are not available, and the 100-mg tablets also are limited.

The National Tuberculosis Controllers Association conducted a survey of 68 jurisdictions to identify issues related to medication procurement, medication supply and TB treatment related to the isoniazid shortage. There were 42 respondents, and 33 reported difficulty in obtaining isoniazid within the previous mount. The shortage led to 18 of 25 TB programs prioritizing high-risk patients for treatment of latent TB infection. Twenty-two TB programs changed to alternate treatment regimens.

“How the increased use of alternative regimens and the rising cost of isoniazid driven by increased demand might affect the future supply of isoniazid and other first-line anti-TB medications is uncertain,” the researchers wrote. “CDC is continuing to work on developing a sustainable solution that will maintain an uninterrupted supply of anti-TB drugs in the United States.”

Disclosure: The researchers report no relevant financial disclosures.