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Frequent antibacterial drug shortages reported in US since 2001
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Between 2001 and 2013, there have been a significant number of antibacterial drug shortages in the United States, with a pronounced increase reported since 2007, according to recent data.
In across-sectional study, researchers reviewed information on drug shortages acquired from the University of Utah Drug Information Service database. A shortage was considered a supply issue affecting requests from pharmacies or instances where a health care provider was forced to prescribe an alternative treatment.
The researchers assessed 1,751 drug shortages, with a focus on antibacterial drugs. The dataset also determined whether shortages were active or resolved, reasons for the shortage, whether the drug was an injectable or the only source of an agent, and whether an alternative drug was available. Each antibacterial drug was further classified based on broad- or narrow-spectrum coverage status and whether it provided coverage against pathogens such as MRSA or Pseudomonas aeruginosa.
The researchers found that 148 antibacterial drugs were in short supply, including 26 remaining on active shortage as of December 2013. There was a median of 10 new shortages annually. Between July 2007 and December 2013, the number of drugs on shortage increased at a rate of 0.35 additional drugs each month (95% CI, 0.22-0.49). The median duration of shortage was 188 days, and 22% of these drugs were on shortage on multiple occasions.
The class of drugs most commonly depleted were cephalosporins (27 reported shortages for 446 months). Forty-six percent of the shortages pertained to drugs used to treat high-risk pathogens, with two for Clostridium difficile, one for carbapenem-resistant Enterobacteriaceae, one for leprosy, 15 for MRSA and 32 for P. aeruginosa. Nearly half of the drugs had no reported alternative source of production.
According to the researchers, these shortages, particularly those used to treat multidrug-resistant infections, are concerning.
“Given that 46% are used in the treatment of high-risk pathogens, such as MRSA, CRE, and Pseudomonas, it is imperative to develop a comprehensive strategy to mitigate the implications of shortages on clinical practice and patient outcomes, including improved communication, alternative algorithms, and antimicrobial stewardship policies,” the researchers wrote. — by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.
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