(Press-News.org) Shortages of key antibiotics, including gold-standard therapies and drugs used to treat highly resistant infections, are on the rise, according to a new study of shortages from 2001 to 2013 published in Clinical Infectious Diseases and available online. The trends raise serious concerns about the effects on patient care, particularly for infections without effective alternative treatment options.
"We found a tremendous number of drugs that are used to treat life threatening infections that just were not available," said study author Larissa May, MD, of George Washington University. "There are implications that patients may not do as well clinically or potentially even die because these agents are not available."
Analyzing data from the University of Utah Drug Information Service database, a national database of drug shortages, the researchers found that 148 antibiotics experienced shortages during the study period, with an upward trend starting in 2007. Almost half -- 46 percent -- of the shortages involved antibiotics used to treat high-risk pathogens, including C. difficile, carbapenem-resistant Enterobacteriaceae (CRE), methicillin-resistant Staphylococcus aureus (MRSA), and Pseudomonas aeruginosa, among others.
Shortages, as defined by the Food and Drug Administration (FDA), are situations in which the total supply of all clinically interchangeable versions of an FDA-regulated drug product is inadequate to meet the projected demand. A shortage can occur for several reasons, including manufacturer mergers, facility consolidation, manufacturing quality issues, and narrow profit margins for generic drugs.
In the study, a high proportion of recent antibiotic shortages affected broad-spectrum antibiotics, injectable drugs, medications with no alternative sources, or those used to treat infections with limited alternative treatment options or pediatric patients. Many involved gold-standard therapies, such as aztreonam, which treats serious infections in patients allergic to penicillin, and trimethoprim/sulfamethoxazole for the treatment of pneumocystis pneumonia.
Thirty-two antibiotics (22 percent) experienced multiple shortages, with a median duration of more than six months. At the end of the study period in December 2013, 26 antibiotics were still in short supply or not available.
Several measures could help limit the impact of antibiotic shortages on patient care, the study authors noted. Mandatory earlier reporting of shortages by manufacturers would make this information more available, allowing more time to make contingency plans. Similarly, improved communication between pharmacists and clinicians so physicians are aware of shortages earlier--before they attempt to prescribe a drug that's not available--would also help.
Institutions could also prospectively track potential shortages and make recommendations for safe and appropriate alternatives. Antibiotic stewardship efforts, guideline development, and clinician education on alternative treatment options could play important roles as well.
"This is a big problem, one that we don't really yet have a strategy to deal with," Dr. May said. "There are some significant implications for patient care that are very disturbing and are likely to become more significant unless we take steps to mitigate them."
INFORMATION:
Fast Facts
Researchers found that 148 antibiotics experienced shortages between 2001 and 2013, with an upward trend in shortages starting in 2007.
Almost half of the shortages involved antibiotics used to treat high-risk pathogens, including C. difficile, CRE, MRSA, and Pseudomonas aeruginosa.
Mandatory earlier reporting of shortages by manufacturers, improved communication with providers, and recommendations for safe and appropriate alternatives, among other steps, could help with the problems posed by antibiotic shortages.
Editor's note: The study authors' affiliations, acknowledgments, and disclosures of financial support and potential conflicts of interests, if any, are available in the article. The article is embargoed until 12:01 a.m. EDT on Thursday, April 23. This pre-publication link is for media access only:
Antibacterial Drug Shortages From 2001 to 2013: Implications for Clinical Practice
Clinical Infectious Diseases is a leading journal in the field of infectious disease with a broad international readership. The journal publishes articles on a variety of subjects of interest to practitioners and researchers. Topics range from clinical descriptions of infections, public health, microbiology, and immunology to the prevention of infection, the evaluation of current and novel treatments, and the promotion of optimal practices for diagnosis and treatment. The journal publishes original research, editorial commentaries, review articles, and practice guidelines and is among the most highly cited journals in the field of infectious diseases. Clinical Infectious Diseases is an official publication of the Infectious Diseases Society of America (IDSA). Based in Arlington, Va., IDSA is a professional society representing nearly 10,000 physicians and scientists who specialize in infectious diseases. For more information, visit http://www.idsociety.org. Follow IDSA on Facebook and Twitter.
Rapid treatment with a new anti-inflammatory could have a major impact on recovery from spinal cord injury, University of Queensland researchers have found.
UQ School of Biomedical Sciences' Dr Marc Ruitenberg and PhD student Ms Faith Brennan said they made the discovery during laboratory trials with an experimental drug.
Ms Brennan said that excessive inflammation caused additional damage in spinal cord injuries and hindered recovery.
"We found that a molecule called C5aR exacerbates inflammation and tissue damage after spinal cord injury," she said.
"Our study ...
Tick-borne diseases are a major public health problem around the world. Ticks carry and transmit a variety of microbes that cause disease. These illnesses, which include Lyme disease, Rocky Mountain spotted fever, and Tularemia, can cause a variety of symptoms, often serious and sometimes deadly.
Now, just in time for spring and the explosion of ticks in forests, lawns and trails, a new study by researchers from China and the University of Maryland School of Medicine (UM SOM) has uncovered a never-before-seen illness transmitted by ticks. It's possible that the disease ...
Researchers have pinpointed a primary cause of a rare skull disorder in infants, and the discovery could help wounded soldiers, car-wreck victims and other patients recover from disfiguring facial injuries.
"This has a lot more implication than what we initially thought," said Yang Chai, a lead researcher on the study at the Herman Ostrow School of Dentistry of USC. "We can take advantage of these stem cells not only to repair a birth defect, but to provide facial regeneration for veterans or other people who have suffered traumatic injury."
Chai predicted such treatment ...
SAN FRANCISCO--More than 143 million Americans living in the 48 contiguous states are exposed to potentially damaging ground shaking from earthquakes, with as many as 28 million people likely to experience strong shaking during their lifetime, according to research discussed at the annual meeting of Seismological Society of America. The report puts the average long-term value of building losses from earthquakes at $4.5 billion per year, with roughly 80 percent of losses attributed to California, Oregon and Washington.
"This analysis of data from the new National Seismic ...
WEST LAFAYETTE, Ind. - A Purdue University study sheds light on how cell damage is reversed by the cancer drug decitabine and identifies a potential biomarker that could indicate a patient's stage of cancer and response to treatment.
A team led by Joseph Irudayaraj, professor of agricultural and biological engineering, showed that decitabine combats some of the effects of cancer by taking the place of the nucleotide cytosine at specific locations on a replicating DNA strand. By mimicking cytosine, the drug helps "tame" cancerous cells by turning on tumor suppressor genes ...
The immune-boosting properties of breast milk have long been known. Now a team of scientists led by Johns Hopkins pediatric surgeon-in-chief David Hackam, M.D., Ph.D., says experiments in mice reveal how breast milk works to ward off the development of necrotizing enterocolitis (NEC), a devastating intestinal disorder that affects 12 percent of premature babies and claims the lives of one in four of those who have it.
If affirmed in human studies, the experiments could pave the way to new preventive approaches to stave off NEC in premature babies and spark the development ...
Over the past few years, extracellular vesicles, or membrane sacs secreted from cells, have emerged as important mediators by which cells communicate with their surroundings to regulate a diverse range of biological processes. In addition, specialized roles for extracellular vesicles are beginning to be recognized in various diseases including cancer, infectious diseases and neurodegenerative disorders. Moreover, engineered extracellular vesicles are likely to have applications in drug delivery.
The laboratory of Crislyn D'Souza-Schorey, Morris Pollard Professor and Chair ...
Beverages sweetened with low, medium and high amounts of high-fructose corn syrup significantly increase risk factors for cardiovascular disease, even when consumed for just two weeks by young, healthy men and women, reports a team of researchers at the University of California, Davis.
The study is the first to demonstrate a direct, dose-dependent relationship between the amount of added sugar consumed in sweetened beverages and increases in specific risk factors for cardiovascular disease.
The data reinforce evidence from an earlier epidemiological study showing that ...
COLUMBIA, Mo. -Due to the ever-increasing number of people using social media sites such as Facebook and Twitter, businesses and organizations, such as professional sports teams, are expanding their marketing and communication efforts to engage people with their brands through those sites. Now, Nicholas Watanabe, an assistant teaching professor at the University of Missouri, along with colleagues from MU and Louisiana State University, analyzed Major League Baseball (MLB) teams' use of Twitter to engage and increase fan interest. They found that the more individual teams ...
LEXINGTON, KY. (Apr. 22, 2015) -- It was once thought that effects of a mild head injury -- dizziness, headaches, memory problems -- were only temporary, and the brain would heal over time. However, while the long-term consequences of head trauma are not fully known, growing evidence suggests that even a mild head injury can increase the risk for later-in-life development of dementias such as Alzheimer's disease.
Researchers at the University of Kentucky's Sanders-Brown Center on Aging have been attempting to understand the cascade of events following mild head injury ...
