Skip to main content

September '23 Infectious Diseases Update

Posted by Doug Black, PharmD., Ann Lloyd, PharmD on Sep 18th 2023

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 Web Edition and All Access clients. All other links are available without a Sanford Guide subscription. To receive monthly updates via email, sign up now. 

SEPTEMBER 2023

SARS-CoV-2 / COVID-19

  • September 15, 2023: Interim clinical consideration for COVID-19 vaccination in the US (click here).
  • Sanford Guide SARS-CoV-2 / COVID-19* main page.
  • COVID-19 vaccination in cancer patients: recommendations from NCCN here.
  • Currently authorized vaccines. See COVID-19 Prevention* for table summarizing use and data.
  • ESCMID COVID-19 living guidelines: drug treatment and clinical management (Clin Microbiol Infect 2022;28:222). Available at PMC.
  • Guidelines on COVID-19 diagnosis, serology, treatment and management, and infection prevention: IDSA and NIH.
  • Living WHO guideline on drugs for COVID-19 (BMJ 2021;375:n2936).
  • Living WHO guideline on drugs to prevent COVID-19 (BMJ 2021;372:n526). Available here.
  • Living WHO guideline on prophylaxis against COVID-19 (BMJ 2021;373:n949). Available at PMC.
  • Management of hospitalized adults with COVID-19: a European Respiratory Society living guideline (Eur Respir J 2021;57(4):2100048). Available at PMC.

From CDC

  • 2023-2024 ACIP seasonal influenza vaccine recommendations (MMWR Recomm Rep 2023;72:1-28). PDF here.
  • 2023 ACIP recommendations for the use of pneumococcal vaccines in adults age ≥19 years (MMWR Recomm Rep 2023;72:1-39). PDF here.

Second Indication for Abrysvo

  • The unadjuvanted, bivalent RSV vaccine Abrysvo was approved in August 2023 for active immunization of pregnant individuals at 32 through 36 weeks gestational age for the prevention of lower respiratory tract disease (LRTD) and severe LRTD caused by RSV in infants from birth through 6 months of age.
    • ACIP guidelines are pending regarding preference vs. postnatal nirsevimab-alip for infants.
    • Concern exists regarding excess premature births in trials.
  • FDA news release here.

AMS Pearl - Prioritize Collaboration Between AMS and Sepsis Teams

  • September is Sepsis Awareness Month, and a recent report from the United States Centers for Disease Control and Prevention (CDC) outlined sepsis program activities in acute care hospitals.  In the study, based on data from the 2022 National Healthcare Safety Network (NHSN) annual survey, 73% of hospitals reported having a sepsis committee.  Of those, 55% reported involvement with antimicrobial stewardship (AMS) programs, and 61% monitored and reviewed antimicrobial use in sepsis care.  
  • To further aid hospitals in improving care for sepsis patients, the CDC developed and released the Hospital Sepsis Program Core Elements.  The Core Elements, modeled after the Core Elements of Hospital Antibiotic Stewardship Programs, are designed to support the implementation of existing sepsis guidelines while providing flexibility for hospitals.  AMS programs and sepsis teams should consider partnering to encourage rapid and optimal use of antimicrobials for sepsis.  MMWR Morb Mortal Wkly Rep. 2023;72(34):907-911.

Drug Shortages (US)

  • Bicillin-LA and Bicillin-CR availability: See Dear Healthcare Professional letter here.
  • Antimicrobial drugs or vaccines in reduced supply or unavailable (as of September 14, 2023) due to increased demand, manufacturing delays, product discontinuation by a specific manufacturer, or unspecified reasons: 
    • New shortages since August 6, 2023:
      • Nystatin topical powder
    • Shortage recently resolved:
      • Neomycin 500 mg tablets (9/7/2023)
    • Antibacterial drugs:
      • Aminoglycosides:
        • Amikacin injection
        • Gentamicin injection
        • Tobramycin injection
      • Bacitracin ophthalmic ointment (unavailable)
      • Carbapenems:
        • Meropenem injection
      • Cephalosporins:
        • Cefazolin injection
        • Cefdinir (all oral formulations)
        • Cefixime 400 mg capsules
        • 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),
      • Clindamycin injection
      • Doxycycline oral suspension
      • Fluoroquinolones:
        • Ciprofloxacin injection
        • Ciprofloxacin 0.3% ophthalmic solution
        • Ofloxacin 0.3% ophthalmic solution
      • Glycopeptides, glycolipopeptides, lipopeptides:
        • Vancomycin injection
      • Macrolides/azalides:
        • Azithromycin ophthalmic solution 1% (unavailable)
        • Erythromycin 0.5% ophthalmic ointment
      • Metronidazole injection
      • Neomycin and Polymyxin B Sulfates GU Irrigant
      • Nitrofurantoin oral suspension
      • Penicillins:
        • Amoxicillin (all oral formulations)
        • Amoxicillin-clavulanate (all oral formulations)
        • Dicloxacillin capsules (250 mg, 500 mg)
        • Penicillin G benzathine injection (Bicillin-LA)
        • Penicillin G benzathine/Penicillin G procaine (Bicillin-CR)
        • Penicillin VK tablets (250 mg, 500 mg), oral solution (250 mg/5 mL)
        • Piperacillin-tazobactam injection
      • Polymyxin B sulfate/Trimethoprim sulfate ophthalmic solution
      • Sulfacetamide 10%/Prednisolone 0.2% ophthalmic ointment (unavailable)
      • Sulfanilamide 15% vaginal cream (unavailable)
      • Tedizolid phosphate injection
      • Tedizolid phosphate 200 mg tablets
    • Antifungal drugs: 
      • Amphotericin B injection
      • Amphotericin B Lipid Complex (ABLC)
    • Antimycobacterial drugs: 
      • Isoniazid injection (100 mg/mL)
      • Isoniazid 100 mg, 300 mg tablets
      • Rifampin capsules
    • Antiparasitic drugs:
      • Primaquine
    • Antiviral drugs: 
      • Oseltamivir capsules, powder for oral suspension
      • Podofilox 0.5% topical gel
      • Ribavirin for inhalation solution
      • Valganciclovir tablets, powder for oral solution
    • Vaccines:
      • None
  • Antimicrobial drugs recently discontinued: 
    • Penicillin G procaine 600,000 units/mL IM injection (June 2023)
    • Ritonavir oral solution 80 mg/mL (January 2023)
    • Lindane 1% shampoo (discontinued by Wockhardt USA in June 2022, no other supplier)
    • Quinupristin-Dalfopristin (discontinued by Pfizer in early 2022, no other supplier)
    • Gemifloxacin 320 mg tablet (August 2022, no further US distribution)
    • Gentamicin sulfate 0.3% ophthalmic ointment (July 2022)
    • Mupirocin calcium 2% cream (Bactroban [GSK], June 2020)
    • Bacitracin injection (February 2020)
    • Interferon alfa-2b (Intron A, October 2019)
    • Mupirocin calcium 2% nasal ointment (Bactroban Nasal [GSK], August 2019)
!