Managing antibiotic shortages: lessons from EAHP and ECDC surveys.

AIMS AND OBJECTIVE: To compare antibiotic shortages in Europe between 2013 and 2020 and the views of hospital pharmacists on overcoming shortages via antimicrobial stewardship. METHODS: A series of European Association of Hospital Pharmacists (EAHP) surveys on medicine shortages, including a survey on the future crisis preparedness of hospital pharmacies, conducted between 2013 and 2020 were compared for the type of antibiotic shortages and respective mitigation strategy. These were analysed taking into account hospital pharmacists' views on antibiotics provided in the European Centre for Disease Prevention and Control (ECDC) survey on healthcare professionals' knowledge, attitudes and behaviours about antibiotics, antibiotic use and antibiotic resistance from 2018. RESULTS: Since 2013 there has frequently been a shortage of antibiotics in European hospitals. In 2014, 67% (347/521) of hospital pharmacists experienced shortages of antimicrobials compared with 77% (1032/1348) in 2018, 63% (1158/1837) in 2019 and 37% (539/1466) in 2020. More than 80% of hospital pharmacists managed antibiotic shortages through substitution in 2014 (284/336) and 2018 (786/946), while this percentage was 40% (63/158) and 42% (620/1466) in 2019 and 2020, respectively. Although 72% (870/1204) of hospital pharmacists received information on how to avoid inappropriate antibiotic prescribing, dispensing and administration, only 37% (450/1204) changed their views and 28% (338/1204) changed their practice in steering antimicrobial treatment. CONCLUSION: Antibiotic shortages affect proper antimicrobial stewardship because of limited appropriate alternatives, taking into account patients' clinical condition and type of infection. While substitution remains a leading mitigating tool for antibiotic shortages, it carries numerous risks and the potential for antimicrobial resistance and suboptimal health outcomes.

Lessons learnt from the COVID-19 pandemic: results of EAHP survey on the future crisis preparedness of hospital pharmacies.

AIM: The present survey aimed to collect information on the lessons learnt from the COVID-19 pandemic by hospital pharmacists. It focused on the shortages of health goods and the experiences of hospitals during the first phase of the crisis. METHODS: A 17-question survey was conducted by EAHP, looking at the experiences of hospital pharmacists during the COVD-19 pandemic. The survey ran from 16 September to 23 December 2020. Statistical analysis included backward stepwise logistic regression (BSLR), Pearson's χ² test, t-test and one-way ANOVA, as appropriate; p≤0.05 was considered statistically significant. RESULTS: 1466 hospital pharmacists answered the survey fully. 58%, 63% and 69% of them experienced shortages in medicines, disinfectants and personal protective equipment (PPE), respectively. BSLR showed that being a COVID-19 dedicated hospital increased the risk of medicine shortages (OR 1.63, 95% CI 1.15 to 2.31) but the shortages of disinfectants and PPE were lower (OR 0.62, 95% CI 0.44 to 0.88; OR 0.60, 95% CI 0.42 to 0.85). Being a specialised hospital reduced the odds of medicine shortages (OR 0.59, 95% CI 0.40 to 0.88), while countries with a greater percentage of the population infected had increased odds for all three types of shortages (OR 1.16, 95% CI 1.01 to 1.23; OR 1.34, 95% CI 1.19 to 1.50; OR 1.21, 95% CI 1.09 to 1.35). The odds were also higher in answers submitted in September compared with December. The classes of medicines with highest reported shortages were anaesthetics, antibiotics and muscle relaxants. The main entities that provided support were the national competent authorities and manufacturers. CONCLUSION: Medicine shortages affected the work of hospital pharmacists during the early stages of the pandemic. The features of the crisis and the feedback described in this survey can provide interesting insights for a more resilient healthcare framework in the future.

EAHP opinion focusing on the application of the medical device regulations

[...]EAHP calls on the European Commission to make the mapping of the GMDN to the EMDN fully available before May 2021 since it is of relevance for the work of hospital pharmacists. Hospital pharmacists should be involved in the selection, procurement and evaluation of medical devices in the hospital sector with other healthcare professionals, including the management of clinical trials with medical devices and the evaluation of software classified as a medical device. [...]EAHP would like to emphasise again the need for close collaboration between authorities and healthcare professionals. Centring around the theme ‘Hospital Pharmacy 5.0 - the future of patient care’ the scientific programme developed by EAHP’s Scientific Committee did not only provide participants with a look forward but also looked back at the impact that the COVID-19 pandemic has had and still has on the profession. Besides being reflected among the different poster submissions the topic also was the focus of two sessions looking at multi-disciplinary care for COVID-19 patients and the repurposing of treatment options.

The European coalition for vaccination calls on healthcare professionals to get vaccinated against COVID-19

Updates from the European Medicines Agency The European Medicines Agency (EMA) published a direct to healthcare professional communication for Vaxzevria (previously COVID-19 Vaccine AstraZeneca), a plain-language description of medical terms related to medicines use and communications advising against the use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials and on the precautionary marketing suspension of the thalassaemia medicine Zynteglo. Following recent media reports and publications on the use of ivermectin, EMA reviewed the latest published evidence from laboratory studies, observational studies, clinical trials and meta-analyses. Precautionary marketing suspension of thalassaemia medicine Zynteglo The company that markets the gene therapy medicine Zynteglo for treating the rare blood condition beta thalassaemia has suspended sales pending investigation of a safety concern. MDR infographic – identifying medical device software Medical devices are an essential part of the delivery of high-quality healthcare and their procurement and management in the European hospital setting is often under the authority of hospital pharmacist.