Shortages of Antimycobacterial Drugs

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Abstract
Recently, there have been several disruptions in the supply of antimycobacterial drugs, affecting stocks of capreomycin (Lilly), cycloserine (Lilly), ethionamide (Wyeth), aminosalicylate sodium (Lannett), streptomycin (Lilly and Roerig), and clofazimine (Geigy). Even supplies of isoniazid have been slightly affected. As of January 1992, only streptomycin and aminosalicylate sodium remained unavailable. Treatment centers across the United States have been affected by these shortages, and the problem is likely to spread as supplies become exhausted. Because of their relatively low profit margins, all the antimycobacterial drugs could be subject to similar interruptions. Multiple-drug—resistant isolates of Mycobacterium tuberculosis are increasingly common. Therefore, drug shortages could drastically affect the management of this contagious disease. The Food and Drug Administration is working with current manufacturers to resolve the existing problems in supply. Most companies seem willing to continue supplying the drugs. Clinicians at our institution are seeking alternative manufacturers for some of these agents. The short-term importation of aminosalicylate sodium is also being explored. In addition, the following steps can be followed until the situation improves.