According to a study published in Clinical Infectious Diseases, shortages of anti-infective medications used to fight infections represent a public health emergency and can put patients at risk. Frequent shortages of these medications can considerably change clinical care and could result in worse outcomes for patients. Furthermore, the prevalence of multidrug-resistant pathogens is increasing while the development of new anti-infectives has decreased.

At the time of examination, the researchers, led by Marc Scheetz, PharmD, and Milena Griffith, PharmD, from Midwestern University Chicago College of Pharmacy and Northwestern Memorial Hospital in Chicago found that 13% of the 193 medications unavailable in the U.S., were anti-infective medications.

The researchers explained: “Anti-infectives often represent irreplaceable life-saving treatments.” In this time, when drug shortages often last months are are more prevalent, individuals who are hospitalized are particularly vulnerable.

The team discovered that often physicians are forced to use alternative medications, which may not be as effective as several first-line treatments, have been hit by shortages, such as drugs for tuberculosis, enterococcal infections, neurosyphilis, herpes encephalitis, among others.

For instance, the present shortage of the intravenous form of sulfamethoxazole/trimethoprim, a first-line treatment for Pneumocystis jiroveci pneumonia since the 1980s, may lead to worse outcomes for individuals with severe disease.

Currently, the law in the U.S. does not require manufacturers to reveal the cause of drug shortages, however, the researchers highlight multiple supply-side issues that play a role:

  • distributing
  • market shortages due to epidemics
  • procuring raw materials
  • processing
  • perceived shortages
  • new therapeutic indications
  • regulatory compliance

Scheetz explained:

“Multidisciplinary stewardship programs that support the appropriate selection, dosing, route of administration, and duration of antimicrobial therapy, can help front-line clinicians when a first-line anti-infective drug is in short supply.”

Furthermore, hospitals should develop approaches that predict the impact and extent of medication shortages, in addition to identifying therapeutic alternatives that decrease potential worse outcomes.

The researchers conclude that in order to identify and correct shortages of life-saving anti-infective medications, improving oversight by the FDA through congressional legislation may also be needed. Scheetz explained:

“Let your members of Congress know that addressing this issue is important for the proper care of patients.”

Written by Grace Rattue