(262) Frequency and Duration of Antibiotic Shortages: A Global Comparison

Background: Medicine shortages impact healthcare worldwide. For antibiotics specifically the consequences of shortages may be huge, due to the acute need of treatment of infections and possible increase in resistance development due to second-line treatment. Although shortages are a global problem, different healthcare systems may influence the impact of shortages on a national level.

Objectives: To compare the frequency and duration of antibiotic shortages in four countries in three regions: Europe, North America, and Oceania.

Methods: National shortage databases have been searched for antibiotic shortages in 2022 and 2023. Any shortage of ATC J01 antibiotics was included. Data were extracted at ATC-5 level and included information on brand name, formulation, start and end date of the shortage and the impact of the shortage. Data were analysed using descriptive statistics.

Results: A total of 955 shortages were reported in the four countries for 57 different antibiotics. The number of shortages ranged from 159 in Belgium to 444 in Canada. Shortages occurred most often for amoxicillin, amoxicillin + clavulanic acid, and cephalexin. The duration of the shortages varied between several days to almost the entire study period of two years. Most shortages occurred on brand level, suggesting that alternative treatment options with the same active ingredient were available.

Conclusions: Antibiotic shortages occurred on a large scale in the four countries, although there are many differences in frequency and duration. Differences in primary care and insurance systems may contribute to differing impact of shortages, although variations in reporting and definitions of shortages complicates international comparison. Urgently, adverse consequences of shortages on antimicrobial resistance need to be investigated to develop appropriate mitigation strategies.