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June '24 Infectious Diseases Update

Posted by Doug Black, PharmD., Ann Lloyd, PharmD. on Jun 29th 2024

Sanford Guide ID Update features current developments in infectious diseases, curated by the Sanford Guide Editorial Board and our AMS Program Manager. Links marked with a * are available to Sanford Guide All Access & Sanford Guide for Web clients. All other links are available without a Sanford Guide subscription. To receive monthly updates via email, sign up now.

JUNE 2024

Doxy-PEP Guidelines

RSV Vaccine safety

  • Early V-safe and VAERS data during first season of use (MMWR 2024;73:489)
    • Guillain-Barre syndrome (GBS) rates of 5.0 and 1.5 reports per million doses of Abrysvo and Arexvy vaccines, respectively, among US adults ≥60 years of age, which were higher than background rates.
    • A small and inconclusive safety signal related to inflammatory neurologic conditions (acute disseminated encephalomyelitis or GBS) has been reported in trials with both vaccines.

AMS Pearl: Outcomes Related to Beta-Lactam Allergies

  • A study including more than 20,000 patients over a 12-year time period investigated the long-term clinical outcomes associated with beta-lactam allergies documented in the medical record.
  • Documentation of a beta-lactam allergy was not significantly associated with mortality, Clostridioides difficile infection (CDI), or stage 2 or 3 acute kidney injury, but it was associated with an increased odds of antibiotic-resistant infections. Infections with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and the pooled odds of infection with MRSA, VRE, and CDI were associated with documented beta-lactam allergies.
  • Antimicrobial stewardship teams can use the findings of this study to develop interventions to enhance accurate beta-lactam allergy documentation. JAMA Netw Open. 2024;7(5):e2412313. Published 2024 May 1. doi:10.1001/jamanetworkopen.2024.12313

Drug Shortages (US)

  • Bicillin-LA and Bicillin-CR availability: See Dear Healthcare Professional letter here.
  • New shortages:
    • Levofloxacin injection in D5W (29 May 2024)
  • Shortages recently resolved:
    • Nystatin topical powder (22 May 2024)
  • Antimicrobial drugs or vaccines in continued reduced supply or unavailable (as of 10 June 2024) due to increased demand, manufacturing delays, product discontinuation by a specific manufacturer, or unspecified reasons:
    • Antibacterial drugs:
      • Aminoglycosides:
        • Amikacin injection
        • Gentamicin injection (22 Feb 2021)
        • Tobramycin injection
      • Bacitracin ophthalmic ointment
      • Carbapenems:
        • Meropenem injection
      • Cephalosporins:
        • Cefazolin injection (4 Jun 2018)
        • Cefdinir, all oral formulations (29 Jun 2023)
        • Cefixime 400 mg capsules (21 Jan 2022)
        • Cefotaxime injection (FDA is allowing temporary importation of product from SteriMax in Canada, in conjunction with Provepharm Life Solutions and its distributor Direct Success. Click here for details).
      • Chloramphenicol injection (9 Oct 2023)
      • Clindamycin phosphate injection (25 Jun 2015)
      • Fluoroquinolones:
        • Ciprofloxacin injection (13 Jan 2023)
        • Ciprofloxacin 0.3% ophthalmic solution
        • Levofloxacin oral solution, 25 mg/mL (15 Sep 2023)
        • Moxifloxacin 400 mg tablets (6 Dec 2023)
        • Ofloxacin 0.3% ophthalmic solution (22 Dec 2022)
      • Glycopeptides, glycolipopeptides, lipopeptides:
        • Vancomycin injection (1 Jun 2015)
      • Macrolides/azalides:
        • Azithromycin ophthalmic solution 1%
        • Erythromycin 0.5% ophthalmic ointment (8 Jul 2022)
      • Metronidazole injection (20 Oct 2021)
      • Neomycin and Polymyxin B Sulfates GU Irrigant (25 Jun 2023)
      • Nitrofurantoin oral suspension (5 Jun 2018)
      • Penicillins:
        • Amoxicillin, all oral formulations (18 Oct 2022)
        • Amoxicillin-clavulanate, all oral formulations (17 Nov 2022)
        • Ampicillin injection (19 Oct 2023)
        • Dicloxacillin capsules (250 mg, 500 mg)
        • Nafcillin injection (20 Mar 2024)
        • Penicillin G benzathine injection (Bicillin-LA) (1 Feb 2023)
        • Penicillin G benzathine/Penicillin G procaine (Bicillin-CR) (31 Mar 2023)
        • Penicillin VK tablets (250 mg, 500 mg), oral solution (250 mg/5 mL) (17 May 2023)
        • Piperacillin-tazobactam injection
      • Polymyxin B sulfate/Trimethoprim sulfate ophthalmic solution (31 Mar 2023)
      • Rifaximin 200 mg tablets (11 Apr 2024)
      • Sulfacetamide 10%/Prednisolone sodium phos 0.23% oph soln (21 Sep 2023)
      • Sulfanilamide 15% vaginal cream (unavailable)
    • Antifungal drugs:
      • Amphotericin B injection (10 Nov 2022)
      • Amphotericin B Lipid Complex (5 Aug 2022)
    • Antimycobacterial drugs:
      • Isoniazid 100 mg, 300 mg tablets (1 Sep 2022)
      • Isoniazid injection 100 mg/mL (24 Jan 2024)
      • Rifampin capsules
    • Antiparasitic drugs:
      • Nitazoxanide oral susp 100 mg/5 mL (15 Feb 2024)
      • Primaquine tablets 26.3 mg
    • Antiviral drugs:
      • Acyclovir injection (21 Feb 2024)
      • Nirsevimab-alip injection (24 Oct 2023)
      • Oseltamivir capsules, powder for oral suspension (1 Nov 2022)
      • Podofilox 0.5% topical gel
      • Ribavirin for inhalation solution (23 May 2023)
      • Valganciclovir tablets, powder for oral solution (7 Feb 2023)
    • Vaccines:
      • None
  • Antimicrobial drugs recently discontinued:
    • Posaconazole oral susp 40 mg/mL (Dec 2023, by Merck)
    • Sulfacetamide 10%/Prednisolone acetate 0.2% oph ointment (Aug 2023 by Allergan, sole supplier)
    • Penicillin G procaine 600,000 units/mL IM injection (Jun 2023)
    • Ritonavir oral solution 80 mg/mL (Jan 2023)
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