TB drug shortages put U.S. patients in peril, study finds

January 17, 2013
TB drug shortages put U.S. patients in peril, study finds
Supply of many medications needed to fight drug-resistant disease is often intermittent at best.

(HealthDay)—Shortages of key tuberculosis drugs are posing a real hazard to patients throughout the United States, a new report finds.

The shortages are making it even more difficult to treat what's known as multidrug-resistant forms of the infectious respiratory illness, the researchers said. These patients often require so-called "second-line drugs" when the medication of choice fails.

For example, the new report cites the 2011 case of a father and his infant child who had each contracted TB. "Despite intensive efforts by public health personnel to obtain the two drugs [needed], the initiation of treatment was delayed by eight days for both patients, prolonging the father's infectious period and thereby increasing the risk for transmission to the community," wrote a team led by Dr. Barbara Seaworth of the University of Texas Health Science Center.

Matters were even worse for the baby, who had also contracted a form of meningitis and "was placed in a particularly dangerous situation," the researchers noted.

"TB meningitis in young children is a medical emergency, and delays in treatment lead to worse outcomes, such as severe [mental] impairment, epilepsy and death," according to the report published in the Jan. 18 issue of the , a journal of the U.S. .

In this case, both the father and baby did recover fully, but not every case involving may turn out so well, the experts said.

In the new study, the National Controllers Association surveyed TB programs across the United States and found that 81 percent of those that reported having patients with multidrug-resistant TB also said they had problems obtaining the medicines needed to treat these patients.

All of the programs that reported difficulties in obtaining drugs to treat multidrug-resistant TB listed nationwide shortages of the drugs as one of the reasons for the difficulties, according to the report.

In an accompanying editorial, experts noted that since September 2011, the supply of key second-line TB drugs has been "precarious."

"Kanamycin is no longer produced in the United States, streptomycin has been intermittently unavailable because of increased international demand, and capreomycin and amikacin have been available on an intermittent basis in only small amounts because of manufacturing problems and lack of raw materials," according to the editorial.

Other causes included shipping delays (noted in 71 percent of cases), lack of resources (62 percent), and the complicated process of obtaining certain drugs (48 percent).

As a result of difficulties obtaining drugs to treat multidrug-resistant TB, 58 percent of the TB programs reported delays in treating patients, 32 percent said there were lapses or interruptions in patient treatment, and 32 percent said they were forced to use an inadequate—and potentially less effective—treatment regimen.

Shortages disrupt the flow of care, as well, the editorial pointed out, leading to "rationing, increased drug costs, and inefficient use of staff time." They also "increase the risk for medication errors because regimens must be adjusted, leading to confusion over drug administration schedules, adverse reactions [side effects] and [drug-to-drug] interactions," the experts wrote.

Some efforts are underway to help ease the situation. In March of 2011, the Federal Advisory Council for the Elimination of Tuberculosis created a working group to address ongoing drug shortages, and in October 2011, a presidential order directed the U.S. Food and Drug Administration and the U.S. Department of Justice to fight drug shortages occurring across the health care spectrum.

"Reliable, consistent access to second-line drugs will require the collaboration of CDC, FDA, state and local health departments, national health professional societies, and the pharmaceutical industry," the study authors concluded.

Explore further: Drug-resistant TB blamed on Indian treatment flaws

More information: The American Lung Association has more about multidrug-resistant TB.

Related Stories

Drug-resistant TB blamed on Indian treatment flaws

March 23, 2012
(AP) -- India's inadequate government-run tuberculosis treatment programs and a lack of regulation of the sale of drugs that fight it are responsible for the spiraling number of drug-resistant cases that are difficult to ...

Management of TB cases falls short of international standards

February 9, 2012
The management of tuberculosis cases in the European Union (EU) is not meeting international standards, according to new research.

TB drug could reduce mortality for MDR-TB and XDR-TB cases

September 26, 2012
Results from an observational study evaluating a new anti-TB drug have found that the treatment can improve outcomes and reduce mortality among patients with both MDR-TB and XDR-TB.

More research needed on the best treatment options for multidrug-resistant TB

August 28, 2012
The use of newer drugs, a greater number of effective drugs, and a longer treatment regimen may be associated with improved survival of patients with multidrug resistant tuberculosis (MDR-TR), according to a large study by ...

Trial for new drug-resistant TB treatment to begin

March 19, 2012
A global health alliance Monday unveiled plans for the first clinical tests of a new treatment regimen for tuberculosis, including for patients with resistance to existing multidrug programs.

Recommended for you

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

Flu may be spread just by breathing, new study shows; coughing and sneezing not required

January 18, 2018
It is easier to spread the influenza virus (flu) than previously thought, according to a new University of Maryland-led study released today. People commonly believe that they can catch the flu by exposure to droplets from ...

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Zika virus damages placenta, which may explain malformed babies

January 18, 2018
Though the Zika virus is widely known for a recent outbreak that caused children to be born with microencephaly, or having a small head, and other malformations, scientists have struggled to explain how the virus affects ...

Certain flu virus mutations may compensate for fitness costs of other mutations

January 18, 2018
Seasonal flu viruses continually undergo mutations that help them evade the human immune system, but some of these mutations can reduce a virus's potency. According to new research published in PLOS Pathogens, certain mutations ...

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.