SARS-Cov-2 and drug shortages- Trends and lessons from a Caribbean perspective

Satish Jankie,Shalini Pooransingh,Lexley Pinto-Pereira,Arlene Villarroel Stuart

doi:10.48107/cmj.2020.11.002

Abstract

Aim and Objectives To investigate the knowledge, attitudes and practices towards antibiotic use among patients attending a tertiary referral urology unit in south Trinidad. We aimed to investigate the general level of awareness of antibiotics as well as identify patterns of antibiotic misuse which could potentially lead to antibiotic resistance. Results 150 patients were evaluated. Most patients (75.5%) were aware that antibiotics are used to treat bacterial infections. 57.9% also believed that antibiotics may be used to treat viral infections. 48.4% were aware of the potential deleterious effects of antibiotics on the body’s normal flora while 78% were aware of the concept of antibiotic resistance. 28.9% reported using antibiotics without a prescription. Overall, 23.3% reported having done so for a fever or cold while 12.6% did so for urinary symptoms. 68 persons (42.8%) stopped their antibiotics prior to completion of the course duration with most (76.5%) indicating that they did so because they felt better. Conclusion This study demonstrates that while most patients were aware of issues surrounding the use of antibiotics, a significant percentage still harboured several misconceptions. Also, high rates of self-medication with antibiotics were noted, among several worrying patterns of usage.

Highlights

Coronavirus SARS-CoV-2 first reported in Wuhan, China in December 2019 has rapidly infected millions, claimed the lives of a large global population, crippled economies, created a new ‘normal’ and continues to flog the health care system
While drug shortages are not uncommon, the titanic surge of SARS-CoV-2 has led to the use of alternative drugs in place of first line analgesics, neuromuscular blockers, vasopressors and antimicrobials in the United States (3)
Public education is imperative for the unsuspecting consumer and the community to be made aware of any impending drug shortages with recommended changes in therapy to prevent the unknowing purchase of false products

Summary

INTRODUCTION

Coronavirus SARS-CoV-2 first reported in Wuhan, China in December 2019 has rapidly infected millions, claimed the lives of a large global population, crippled economies, created a new ‘normal’ and continues to flog the health care system. Sedatives and painkillers were soon in short supply at hospital pharmacies and clinical pharmacists began to spend more time on drug acquisition and conservation than on patient care (2). While drug shortages are not uncommon, the titanic surge of SARS-CoV-2 has led to the use of alternative drugs in place of first line analgesics, neuromuscular blockers, vasopressors and antimicrobials in the United States (3). Clinical pharmacists have been actively identifying drugs in short supply, considering alternatives and assessing the risks when using these agents. They have been monitoring drug use and reducing drug wastage, which is of paramount importance when there are drug shortages. The United States Drug Enforcement Agency (DEA) promptly approved a 15% increase in production quotas for controlled substances like fentanyl, morphine, hydromorphone, codeine, ephedrine, and pseudoephedrine, and in parallel will permit increased imports of ketamine, diazepam, midazolam, lorazepam, and phenobarbital (6)

DISCUSSION

Active pharmaceutical ingredients

Findings

Can drug shortages be mitigated?

CONCLUSION