Antibiotic Shortages in Pediatrics.

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* Abbreviation: FDA — : US Food and Drug Administration Medication shortages are increasingly common and severe in the United States and are a serious health threat. Medication shortages occur when reduced supply of a drug influences how it is prepared, dispensed, or prescribed by pharmacies or providers.1 According to the US Food and Drug Administration (FDA), most shortages are caused by quality and manufacturing problems.2 Consequences of shortages include rationing limited supplies, delays in therapy, medication errors, use of less-efficacious alternatives, and death.3 Recently, critical drugs like sodium chloride and amino acids have been on shortage, exacerbated by damage to manufacturing plants by natural disasters like Hurricane Maria. Although shortages have affected virtually all classes of medications, antimicrobial shortages are common and account for 15% of all drug shortages.1,4 Medication shortages can force clinicians to treat patients with suboptimal therapy, which, in turn, can lead to poor outcomes. Examples relating to antimicrobial agents are when a penicillin shortage led to use of second-line therapies for neurosyphilis, an intravenous trimethoprim-sulfamethoxazole shortage led to alternative therapies for Pneumocystis jiroveci infections, an acyclovir shortage led to use of alternative antiviral … Address correspondence to Ritu Banerjee, MD, PhD, Vanderbilt University Medical Center, 1161 21st Ave, Nashville, TN 37232. E-mail: ritu.banerjee{at}vumc.org