Shortages of systemic antibiotics in the USA: how long can we wait?

Objectives Drug shortages have risen steadily in the USA. Systemic antibiotics are most frequently in short supply raising concerns about public health safety and patient care. We sought to assess the prevalence and characteristics of systemic antibiotics in short supply as reported by federal agencies and private healthcare providers in the USA on 1 June 2011. Methods Data derived from the US Food and Drug Administration, American Society of Health-System Pharmacists and the Brigham and Women's Hospital. The units of analysis were active ingredient(s) and route of administration. Key findings Overall, 18 antibiotic active ingredients, with 20 routes of administration, were in short supply on 1 June 2011. The prevalence varied from 5.7% reported by the Food and Drug Administration and Brigham and Women's Hospital to 28.3% reported by the American Society of Health-System Pharmacists. Injectable antibiotics had the highest (28.3%) level of shortage. Shortages occurred because of problems with manufacturing (35.0%) and raw materials (15%. 0), and for unknown reasons (45.0%). The average duration of the shortages was 591.7 +/- 304.9 days. Conclusions Over one-fifth of the systemic antibiotics (one-quarter of the injectables) marketed in the USA were reported to be in short supply on 1 June 2011. One-half of the shortages were attributed to problems with manufacturing and raw materials although reasons for shortages are often unknown.