Emergency Medicine and Trauma Center, Children's National Health System, Washington, DC.
The Center for Healthcare Innovation and Policy Research, George Washington University, Washington, DC.
J Pediatr. 2018 Aug;199:65-70. doi: 10.1016/j.jpeds.2018.04.008. Epub 2018 May 8.
To describe contemporary drug shortages affecting general ambulatory pediatrics.
Data from January 2001 to December 2015 were obtained from the University of Utah Drug Information Service. Two pediatricians reviewed drug shortages and identified agents used in ambulatory pediatrics. Shortage data were analyzed by the type of drug, formulation, reason for shortage, duration, marketing status, if a pediatric friendly-formulation was available, or if it was a single-source product. The availability of an alternative, and whether that alternative was affected by a shortage, also was noted.
Of 1883 products in shortage during the study period, 314 were determined to be used in ambulatory pediatrics. The annual number of new pediatric shortages decreased initially but then increased to a high of 38 in 2011. Of the 314 pediatric shortages, 3.8% were unresolved at the end of the study. The median duration of resolved shortages was 7.6 months. The longest shortage was for ciprofloxacin 500-mg tablets. The most common class involved was infectious disease drugs. Pediatric-friendly dosage forms were affected in 19.1% of shortages. An alternative agent was available for 86% drugs; however, 29% of these also were affected. The most common reason for shortage was manufacturing problems.
Drug shortages affected a substantial number of agents used in general ambulatory pediatrics. Shortages for single-source products are a concern if a suitable alternative is unavailable. Providers working in the ambulatory setting must be aware of current shortages and implement mitigation strategies to optimize patient care.
描述影响普通门诊儿科的当代药物短缺情况。
从 2001 年 1 月至 2015 年 12 月，从犹他大学药物信息服务处获取数据。两位儿科医生审查了药物短缺情况，并确定了在普通儿科门诊中使用的药物。根据药物类型、制剂、短缺原因、持续时间、营销状况、是否有儿童友好型制剂以及是否为单一来源产品来分析短缺数据。还记录了替代药物的可用性，以及替代药物是否受到短缺的影响。
在研究期间的 1883 种短缺产品中，有 314 种被确定用于普通儿科门诊。每年新出现的儿科短缺数量最初减少，但随后在 2011 年增加到 38 个的高峰。在 314 种儿科短缺中，有 3.8%在研究结束时仍未解决。已解决的短缺的中位数持续时间为 7.6 个月。持续时间最长的短缺是环丙沙星 500mg 片剂。涉及的最常见类别是传染病药物。在 19.1%的短缺中，儿童友好型剂量形式受到影响。对于 86%的药物，有替代药物可用；但是，其中 29%也受到影响。短缺的最常见原因是生产问题。
药物短缺影响了普通门诊儿科中大量使用的药物。如果没有合适的替代品，单一来源产品的短缺令人担忧。在门诊环境中工作的提供者必须了解当前的短缺情况，并实施缓解策略，以优化患者护理。
