Antimicrobial Drug Shortages

Medication shortages can compromise patient care, and adversely affect drug therapy and/or increase medication errors by use of suboptimal or unfamiliar alternatives. Numerous antimicrobial agents have been affected by national drug shortages, over the last 10 years shortages rose over 250%, 2nd only to oncologic agents. From 2001-2013, there were over 150 antimicrobials on national shortage; by 2013, 112 of them were resolved, over a dozen agents had been discontinued completed from the market. In 2015, the Infectious Disease Society of America (IDSA) released a comprehensive statement in regards to drug shortages. The average antimicrobial is on shortage for 750 days (range: 69 days – 2200 days).

Below is a non-inclusive list of some the antimicrobials that are on shortage or completely unavailable. This is not an exhaustive list, and medications go on and off of shortage lists almost daily. The purpose of this is to communicate to providers a list of potential antimicrobials that could be or have been affected at Children’s of Alabama. The ASP team will work to communicate new, or updated shortages in real time to the medical staff and providers so that alternative therapies can be considered.

ANTIMICROBIAL SHORTAGES   RECENTLY DISCONTINUED PRODUCTS
  • Acyclovir Injection
  • Amphotericin Deoxycholate (conventional) – restricted to ID approval
  • Azithromycin IV (restricted to strict NPO) – ID approval for use outside patients with strict NPO including medication orders
  • Bicillin L-A (penicillin G benzathine) IM – all formulations restricted due to extreme national drug shortage. Use restricted to Congenital Syphilis and ID approval
  • Cefotaxime Injection – long term shortage.  Reserved for neonatal sepsis (patients less than 22 days of age)
     
 
  • Azithromycin 1gram packets for suspension – discontinued product, use 500mg tablets instead to complete dose
  • Bezlotoxumab Injection – antibody therapy for refractory C.difficile infection.  Removed from market with no alternative product available
  • Bicillin (penicillin G procaine) IM 600,000units/ml – all formulations removed from market (1ml and 2ml doses) - P
  • Gentamicin 0.3% Ophthalmic ointment – removed from market;  (Tobramycin ointment and drops available)
  • Ribavirin Solution for Oral Inhalation – removed from market. When indicated per ID, oral tablets and capsules are available.