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2001 年至 2013 年抗菌药物短缺:对临床实践的影响。

Antibacterial drug shortages from 2001 to 2013: implications for clinical practice.

机构信息

Department of Emergency Medicine, George Washington University.

MedStar Washington Hospital Center, Washington D.C.

出版信息

Clin Infect Dis. 2015 Jun 15;60(12):1737-42. doi: 10.1093/cid/civ201. Epub 2015 Apr 22.

Abstract

BACKGROUND

Previous studies have described drug shortages; however, there has been no comprehensive evaluation focusing on US antibacterial shortages.

METHODS

Drug shortage data from the University of Utah Drug Information Service database were analyzed, with a focus on antibacterial agents from 2001 to 2013. We used descriptive statistics to describe trends in drug shortages, analyze drug classes commonly affected, and investigate whether drugs experienced multiple periods of shortages.

RESULTS

One hundred forty-eight antibacterial drugs were on shortage over the 13-year study period, with 26 drugs still active on shortage as of December 2013. The median number of new shortages per year was 10 (interquartile range [IQR], 7). The number of drugs on shortage increased at a rate of 0.35 additional drugs every month (95% confidence interval, .22-.49) from July 2007 to December 2013 (P < .001). The median shortage duration was 188 days (IQR, 366.5). Twenty-two percent of drugs experienced multiple shortage periods.

CONCLUSIONS

There were a substantial number of drug shortages from 2001 to 2013, with a dramatic rise in shortages since 2007. Shortages of agents used to treat multidrug-resistant infections are of concern due to continued transmission and limited treatment options.

摘要

背景

之前已有研究描述了药品短缺的情况,但缺乏对美国抗菌药物短缺的全面评估。

方法

分析了犹他大学药物信息服务数据库中的药品短缺数据,重点关注 2001 年至 2013 年的抗菌药物。我们使用描述性统计来描述药品短缺趋势,分析受影响的常见药物类别,并调查药物是否经历了多次短缺期。

结果

在 13 年的研究期间,有 148 种抗菌药物出现短缺,截至 2013 年 12 月,仍有 26 种药物处于短缺状态。每年新增短缺药物的中位数为 10 种(四分位距[IQR],7)。从 2007 年 7 月至 2013 年 12 月,每月短缺药物的数量以 0.35 种的速度增加(95%置信区间,0.22-0.49)(P<0.001)。短缺持续时间的中位数为 188 天(IQR,366.5)。22%的药物经历了多次短缺期。

结论

2001 年至 2013 年期间发生了大量的药品短缺,自 2007 年以来短缺情况急剧增加。用于治疗多重耐药感染的药物短缺令人担忧,因为这些感染持续传播且治疗选择有限。

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