There is a serious health care crisis being confronted by the United States at this time which does not often gain the necessary attention. It has been reported by ScienceDaily "Anti-Infective Drug Shortages Pose Threat to Public Health and Patient Care." According to a review which has been published in Clinical Infectious Diseases shortages of key drugs which are used to fight infections represent a public health emergency and can put patients at risk. Clinical care can be substantially altered by frequent anti-infective shortage which may lead to worse outcomes for patients.
This is particularly true as the development of new anti-infectives has slowed and the prevalence of multidrug-resistant pathogens is seen to be increasing. The authors of this report, led by Marc Scheetz, PharmD, and Milena Griffith, PharmD, from Midwestern University Chicago College of Pharmacy and Northwestern Memorial Hospital in Chicago, found that of the 193 medications unavailable in the U.S. at the time of the analysis, 13 percent were anti-infective drugs. The authors commented "Anti-infectives often represent irreplaceable life-saving treatments."
Hospitalized patients have been found to be particularly vulnerable to drug shortages in an era when such shortages often last months and are occurring more frequently. Shortages have been experienced for first-line treatments for herpes encephalitis, neurosyphilis, tuberculosis, and enterococcal infections, among others. This can force physicians to use other drugs which may not work as well. Consider for example, the current shortage of the intravenous form of sulfamethoxazole/trimethoprim, which is a first-line treatment for Pneumocystis jiroveci pneumonia since the 1980s, may result in adverse outcomes for patients who are suffering from severe disease.
Current U.S. law does not require manufacturers to disclose the details related to the primary cause of drug shortages which can therefore be hard to determine. The authors have conjectured several supply-side issues may play a role, such as procuring raw materials, processing, distributing, regulatory compliance, market shortages due to epidemics, new therapeutic indications, and perceived shortages. Scheetz has pointed out multidisciplinary planning and management of resources which 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.
It has also been advised that hospitals should develop strategies which anticipate the impact and extent of drug shortages, as well as identify therapeutic alternatives that mitigate potential adverse outcomes. And the authors have concluded that enhancing oversight by the Food and Drug Administration through congressional legislation may be needed in order to identify and correct shortages of life-saving anti-infective drugs. Scheetz has said "Let your members of Congress know that addressing this issue is important for the proper care of patients." The issue of anti-infective drug shortages is a serious issue which has been appropriately considered in this study.
