Antimicrobial Shortages

Antimicrobial Shortages

Antimicrobial Shortages Section

Content is updated as new information becomes available

Drugs on Shortages

Click/tap to expand each listing for detailed information on shortage, clinical management, and alternative antibiotic recommendations

Shortage Start: February 2023

Shortage Resolved: Ongoing

Interim Guidance:

  • Clinical Considerations: Clindamycin is lincosamide antibiotic with activity against gram-positive organisms and some gram-negative anaerobes, historically used in a variety of skin and soft tissue infections and as adjunctive therapy for toxin-mediation in toxic-shock syndromes
    • Susceptibility to clindamycin is declining for many organisms
    • Locally, susceptibility for Staphylococcus spp. (including MSSA and MRSA) is <80%.
    • Regardless of shortages status, Northern Light Health generally recommends against the use of clindamycin outside of its role in toxin-mediation and is absent from NLH treatment guidelines
  • Alternatives (See disease specific guidelines for full recommendations and dosing):
    • Non-purulent SSTIs:
      • Preferred: Cefazolin or cephalexin/cefadroxil always preferred for superior activity v.s. typical skin organisms.
      • True cephalosporin allergy: Sulfamethoxazole-trimethoprim is a reasonable oral option for patients with true cephalosporin allergies as it provides reliable coverage v.s. Staphylococcus spp. and Group A Streptococcus. If IV therapy is required for patients with true cephalosporin allergies, vancomycin is preferred
    • Purulent SSTIs:
      • Preferred: Sulfamethoxazole-trimethoprim or doxycycline provide superior activity v.s. MRSA compared to clindamycin. PO linezolid is also a reasonable option if contraindications to SMX-TMP/doxycycline. If IV therapy is needed, vancomycin is preferred over clindamycin
    • Mediation of Toxin Release (toxic-shock syndrome):
      • Preferred: Clindamycin continues to be preferred.
      • Alternative: This recommendation will be updated with alternatives if clindamycin is no longer available

Resolved Shortages

Shortage info will be maintained for 3 months from shortage resolution date and then removed

Shortage Start: November 2022

Shortage Resolved: Resolved mid-January 2023

Products Impacted: All dosage forms

Interim Guidance:

Tiered criteria for oseltamivir use were developed by Northern Light Infectious Diseases specialists to ensure adequate stock to treat the highest risk patients. More information can be seen using the link below.

This shortage is resolved as there is now adequate oseltamivir supply.

Shortage Start: November 10, 2022

Shortage Resolved: Resolved early February 2023

Products Impacted: 

  • Amoxicillin suspension: 125 mg/5 mL, 200 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL
  • Amoxicillin tablets are not affected and remain available to use.

Interim Guidance:

The Northern Light Bug-Drug Guide provides alternative therapeutic recommendations in pediatrics for bacterial pharyngitis, acute otitis media, and pneumonia. Questions regarding the Northern Light Bug-Drug guidelines or antimicrobial therapies can be submitted to your local Antimicrobial Stewardship Team (See your local stewardship contacts here) or submitted to the System Antimicrobial Stewardship Specialist:

Kelly Sawyer, PharmD, BCIDP

This shortage is resolved as there is now adequate supply of amoxicillin suspension.