MARCH 2024

by Editorial Board last updated Apr 09, 2024 02:28 PM

SARS-CoV-2 / COVID-19

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 vaccines (Age ≥12 yrs) and COVID-19 vaccines (Age <12 yrs) for 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 (last updated 6/26/23)
- NIH (last updated 12/20/23)
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.

New Rilpivirine Pediatric Dosage Formulation

Rilpivirine 2.5 mg tablets for oral suspension (EDURANT PED) have been approved by the US FDA for the treatment of HIV-1 in combination with other antiretroviral therapies in treatment-naïve children (with HIV-1 RNA <100,000 copies/mL) at least 2 years of age and weighing at least 14 kg and less than 25 kg. They must be dispersed in 5 mL water and ingested immediately (not chewed or swallowed whole). The new 2.5 mg tablets and the original 25 mg film-coated tablets differ in bioavailability and are thus not interchangeable on a mg-per-mg basis.

Tuberculosis Preventive Treatment: Update from WHO

In a Rapid Communication, the World Health Organization (WHO) has announced a number of updates to its forthcoming 2nd edition of the guidance on tuberculosis preventive treatment (TPT). The primary update is a recommendation to use a regimen of six months of levofloxacin as TPT for contacts of patients with multidrug- or rifampin-resistant TB, based on the results of two RCTs in Vietnam and South Africa that support the use of the regimen in all age groups. Other revisions include updated drug dosages for TPT regimens with levofloxacin and rifapentine, integration of recommendations on screening strategies to rule out TB ahead of starting TPT and the use of TB tests, and an update of the algorithm for the management of TPT in contacts. The updated guidance will be released later this year. The Rapid Communication is available here.

Drug Shortages (US)

Bicillin-LA and Bicillin-CR availability: See Dear Healthcare Professional letter here.
New shortages:
- Acyclovir injection (21 Feb 2024)
- Nitazoxanide oral susp 100 mg/5 mL (15 Feb 2024)
Shortages recently resolved:
- Cefixime capsules 400 mg (9 Jan 2024)
Antimicrobial drugs or vaccines in continued reduced supply or unavailable (as of 10 Mar 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)
  - Doxycycline oral suspension (16 Nov 2021)
  - 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
  - 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
  - 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)
    - 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)
  - 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)
  - Nystatin topical powder (18 Aug 2023)
- Antimycobacterial drugs:
  - Isoniazid 100 mg, 300 mg tablets (1 Sep 2022)
  - Isoniazid injection 100 mg/mL (24 Jan 2024)
  - Rifampin capsules
- Antiparasitic drugs:
  - Primaquine
- Antiviral drugs:
  - 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/