JUNE 2024

Doxy-PEP Guidelines

CDC guidelines on the use of doxycycline postexposure prophylaxis for prevention of chlamydia, gonorrhea, and syphilis (MMWR Recomm Rep 2024;73:1-8). PDF available here.

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.

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)

For more detailed information including estimated resupply dates, see https://www.ashp.org/Drug-Shortages/