NEW ORLEANS – Data show that antimicrobial shortages have continued since 2011, according to research presented by members of the Emerging Infection Network (EIN) at ID Week 2016.

In early 2016, physicians with the EIN distributed a web-based survey to infectious disease (ID) physicians, querying network members about antimicrobial drug shortages. Nearly half of all members (44%) responded to the survey, with 70% of respondents indicating that the shortages resulted in a modification of their antimicrobial choice. A majority of respondents (73%) also reported that shortages had affected patient care or outcomes due to the use of broader-spectrum (75%), more costly (58%), less effective second-line (45%), or more toxic agents (37%).

Respondents indicated being made aware of the shortages via hospital notification (76%), from a colleague (56%), from a pharmacy, after ordering an antimicrobial (53%), or from the US Food and Drug Administration (FDA) or another website that reported on the shortages (23%); 71% of respondents felt that communications related to shortages were sufficient during 2016. Eighty-three percent of participants said that their institutions had developed guidelines to effectively deal with the shortages.


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The top 10 antimicrobials with shortages were:

  • Piperacillin-tazobactam
  • Ampicillin-sulbactam
  • Meropenem
  • Cefotaxime
  • Cefepime
  • Trimethoprim-sulfamethoxazole
  • Doxycycline
  • Imipenem
  • Acyclovir
  • Amikacin

The number of physicians noting an increase in adverse patient outcomes directly related to the shortages increased from 2011 to 2016 (51% to 73%, P <.0001).

“The persistence of antibiotic shortages reported 5 years after the last survey is disturbing, as is the continued need to use broader-spectrum or more toxic agents,” noted Adi V. Gundlapalli, MD, PhD, associate professor of internal medicine at the University of Utah School of Medicine and the University of Utah Hospitals and Clinics, and colleagues. “Although ID physicians are learning about shortages sooner, more local system resources are needed for antimicrobial stewardship programs in order to respond to persistent, recurrent, and rotating antimicrobial shortages.”

Disclosures: Dr Graham reports receiving research grants and speakers bureau honoraria from Theravance Biopharma US Inc.

Reference

Gundlapalli A, Beekmann SE, Graham D, Polgreen PM; and members of the Emerging Infections Network. Antimicrobial agent shortages and concerns for adverse patient outcomes are now part of everyday practice. Presentation at: ID Week 2016; October 26-30, 2016; New Orleans, LA. Abstract 1679.