Abstract
Background. Drug shortages are an increasing and worldwide
problem. Oral antibiotics are one of the most used medicines worldwide
and have recently been affected by drug shortages. Despite this, little
is known about the impact of antibiotic shortages on clinical and
prescribing practices. Aim. To explore the impact of oral
antibiotic shortages on national antibiotic utilisation.
Methods. A longitudinal study of oral antibiotic shortages and
antibiotic utilisation was conducted using Australian reimbursement and
regulatory data from January 2022 to December 2023. All nationally
reimbursed oral antibiotics were included in the study. The number and
duration of reported antibiotic shortages per product were determined
for each active ingredient. The clinical impact was assessed using
national utilisation in Defined Daily Doses per 100,000 inhabitants.
Changes in trends were analysed using Joinpoint regression.
Results. Shortages were reported for eighteen of the twenty-one
(86%) oral antibiotics reimbursed in Australia. No clear relation
between the number and duration of shortages was observed for most
antibiotics. Changes in utilisation coinciding with shortages were
observed for eight active ingredients. For cefaclor (-20% decrease in
utilisation) and roxithromycin (-26% decrease), the impact of shortages
is most clearly reflected by decreases in utilisation. For the other
six, either minor or mixed changes in utilisation were observed.
Conclusions. Antibiotic shortages were common in Australia
during 2022 and 2023. The impact of shortages appears complex with
various factors most likely influencing impact. Australia’s healthcare
professionals seem successful in mitigating the effects of shortages on
drug utilisation.