Drug Shortages and Rapid Price Escalation: The Latest on the Crisis

The American health system is now into the seventh year of an unprecedented and unplanned shortage of emergency medications. The causes of the shortage continue to be debated, but the root cause is the American manufacturers of intravenous medications, and disputes between those manufacturers and the Federal agencies that oversee drug supply and manufacturing practices (FDA and DEA), over safe manufacturing and quality processes. The Crisis There are now life-threatening problems with medication supplies for EMS providers across all classes of emergency medicines. As of June 26, 2017, there are 69 preparations of 28 emergency care preparations that are in short supply, including most forms of adenosine, atropine, bicarbonate, calcium, dextrose, dopamine, epinephrine, fentanyl, labetalol, magnesium, and lorazepam. There are an additional 50 large volume intravenous fluid preparations that are not available. The media has featured the hospital shortage of bicarbonate, which affects a wide range of patients.  There has been no media attention to the prices of the medications that are available, but any EMS leader who is responsible for the budget is aware that prices of all medications have increased dramatically. FDA Response In response to significant pressure from the emergency community, the FDA has taken two actions: 1) It has approved the sourcing of sodium bicarbonate from an Australian medication manufacturer, a step that mirrors a prior action allowing the importat...
Source: JEMS Operations - Category: Emergency Medicine Authors: Tags: News Operations Source Type: news

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CONCLUSION: Prevalence of antibiotic use was high not only versus other hospitals in the region but globally including Africa, coupled with significant evidence of sub-optimal prescribing. Swift action is needed to improve future prescribing to reduce AMR. One or two areas should initially be targeted for quality improvement including development of local guidelines, documentation of antibiotic indications and/or stop/review dates. PMID: 33034234 [PubMed - as supplied by publisher]
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
Authors: Rombauts A, Abelenda-Alonso G, Cuervo G, Gudiol C, Carratalà J Abstract INTRODUCTION: Despite adequate antibiotic coverage, community-acquired pneumonia (CAP) remains a leading cause of hospitalization and mortality worldwide. It induces both a local pulmonary and a systemic inflammatory response, particularly significant in severe cases. The intensity of the dysregulated host response varies from patient to patient and has a negative impact on survival and other outcomes. AREAS COVERED: This comprehensive review summarizes the pathophysiological aspects of the inflammatory response in CAP, brie...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
Authors: Hammerschlag MR, Sharma R Abstract INTRODUCTION: Azithromycin was recommended as the first-line therapeutic regimen for treatment of genital infections in men and women by the Centers for Disease Control in 1998. A series of studies of azithromycin for treatment of rectal chlamydial infection in men who have sex with men (MSM) found that azithromycin was significantly less effective than doxycycline. AREAS COVERED: Literature on treatment of rectal C. trachomatis from 2000 through May 2020 was searched using PubMed. Retrospective and observational studies were identified documenting the frequency and t...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
Authors: Reissier S, Cattoir V Abstract INTRODUCTION: Streptogramins (pristinamycin and quinupristin-dalfopristin) can be interesting options for the treatment of infections due to Gram-positive cocci, especially multidrug-resistant isolates. AREAS COVERED: This review provides an updated overview on structural and activity characteristics, mechanisms of action and resistance, pharmacokinetic/pharmacodynamic and clinical use of streptogramins. EXPERT OPINION: The streptogramin antibiotics act by inhibition of the bacterial protein synthesis. They are composed of two chemically distinct compounds, namely typ...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
Publication date: 15 February 2021Source: Journal of Hazardous Materials, Volume 404, Part BAuthor(s): Ping He, Yi Zhang, Xinyi Zhao, Jie Wei, Tianhong Xu, Jiang Wu, Naichao Chen
Source: Journal of Hazardous Materials - Category: Environmental Health Source Type: research
Publication date: 15 February 2021Source: Journal of Hazardous Materials, Volume 404, Part BAuthor(s): Jing Li, Haotian Li, Dongdong Lin, Muyi Li, Quansheng Wang, Song Xie, Yuming Zhang, Fengsong Liu
Source: Journal of Hazardous Materials - Category: Environmental Health Source Type: research
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Source: Journal of Hazardous Materials - Category: Environmental Health Source Type: research
Publication date: 15 February 2021Source: Journal of Hazardous Materials, Volume 404, Part AAuthor(s): Cheng Han, Yinping Zhang, Marc Redmile-Gordon, Huan Deng, Zhenggui Gu, Qiguo Zhao, Fang Wang
Source: Journal of Hazardous Materials - Category: Environmental Health Source Type: research
Publication date: 15 February 2021Source: Journal of Hazardous Materials, Volume 404, Part AAuthor(s): Taesik Go, Jihwan Kim, Sang Joon Lee
Source: Journal of Hazardous Materials - Category: Environmental Health Source Type: research
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Source: Journal of Hazardous Materials - Category: Environmental Health Source Type: research
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