The Dutch regulatory agency has raised concerns about a shortage of narrow-spectrum antibiotics. A lack of such targeted therapies is forcing doctors to use broad-spectrum antibiotics that increase the risk of antimicrobial resistance emerging.
Officials at the Dutch Medicines Evaluation Board (MEB) issued a warning about the situation after seeing a rise in the number of companies that are struggling to supply narrow-spectrum products. MEB thinks the situation has worsened over the past few years and the number of alternative drugs available to doctors affected by shortages has shrunk. The result is doctors are prescribing antibiotics that affect a wide range of microorganisms, rather than specifically targeting the cause of an illness.
Dutch doctors are generally cautious about prescribing antibiotics, reflecting wider efforts to curb the use of such drugs in Europe. However, this has reduced the size of the Dutch market for antibiotics, making the sector less economically attractive to pharmaceutical companies. MEB thinks this is one driver of the increase in antibiotic shortages.
The regulator also mentioned raw material shortages as a factor. Days later, MEB issued a statement about an impending shortage of GlaxoSmithKline’s Bactroban, an antibiotic ointment used to treat staphylococcus infections in the nose. Supply is expected to stop from June to September. GSK attributed the constraints to problems in its raw material supply chain.
The Bactroban shortage illustrates some of the concerns raised by MEB. As well as being linked to raw material issues, the shortage validates MEB’s comments about the lack of alternatives available to doctors. With no alternative to Bactroban available, MEB is advising doctors to limit use of the drug to certain groups of patients, such as those who have Methicillin-resistant Staphylococcus aureus (MRSA) or are suffering from an infection prior to particular surgical procedures.
Patients who fall outside these groups may receive oral treatments. This is an imperfect solution, but means patients will be able to access a treatment during the shortage, as is typically the case in the Netherlands. An MEB report found that companies made almost 400 reports about problems with the supply of medicines last year. Alternative treatments were found in all but one case.