PENICILLIN supplier CSL is under fire for taking too long to alert health authorities to its shortage of the drug.
Doctors say they could have started rationing the antibiotic sooner had they been kept informed.
As the Commonwealth's Chief Medical Officer, Chris Baggoley, last night sent out a contingency plan to hospitals to deal with the problem, CSL medical director Alan Paul revealed the company had known it was low on the drug in late August.
The company sent a letter to hospitals on September 20, advising them to start rationing it and Professor Baggoley said he was made aware of the shortage on Monday.
Infectious disease specialists were outraged by the timing yesterday.
Some said they would have started preserving supplies in August if they were advised of a potential shortage by CSL.
Professor Baggoley told The Age last night that he would have also appreciated more time. He said the TGA was trying to find another supplier if it became necessary. "It implies that for a month we've been using penicillin stocks that we could have put to better use," said Peter Collignon, an infectious disease specialist based at the Australian National University in Canberra.
"The other issue is that it would have given us a better opportunity to look for alternative supplies," he said.
In its letter to hospitals last week, CSL said a delivery delay meant it had a restricted supply of intravenous penicillin the drug of choice for serious illnesses, including pneumonia, heart valve infections and bacterial meningitis.
The company, which is the only one with an agreement to distribute the drug in Australia, does not expect to get more stock out until December.
The federal government says patient care will not be compromised, but infectious disease doctors said it would lead to substandard care for some patients, while forcing them to use broad-spectrum antibiotics, which encourage the spread of potentially fatal superbugs.
Professor Collignon said CSL needed to explain exactly how the shortage had come about, given that other drug companies had moved away from the antibiotic market in recent years because they were less profitable than other drugs.
It also came after disruptions to other drug supplies in recent years, including tuberculosis and malaria treatments. Professor Collignon said the federal government needed to review its systems and ensure Australia had several companies supplying such crucial drugs as penicillin.
A spokeswoman for CSL said it was expecting stock to arrive in August, but the pharmaceutical company Sandoz had told them its order would not arrive until late November. She said that when it was clear there would be a shortage, CSL alerted the Therapeutic Goods Administration and some hospitals verbally to allow them to prepare but she refused to say when this happened.
A spokeswoman for the federal Department of Health refused to say when it became aware of the problem and said Professor Baggoley had issued advice to hospitals about other antibiotics, which would not encourage the growth of superbugs.
Frequently Asked Questions about this Article…
What is the penicillin shortage in Australia and which company is involved?
The article reports a shortage of intravenous penicillin in Australia. CSL, the company with the agreement to distribute that penicillin in Australia, has been criticised for the timing of its warnings to health authorities and hospitals.
When did CSL tell hospitals and health authorities about the penicillin supply problem?
CSL's medical director said the company knew stocks were low in late August. CSL sent a letter to hospitals on September 20 advising them to start rationing. A spokeswoman also said CSL verbally alerted the Therapeutic Goods Administration (TGA) and some hospitals, but would not say when those verbal alerts occurred.
How long is the penicillin supply expected to remain restricted?
CSL told hospitals it had a restricted supply and does not expect to get more stock out until December. CSL also said it had expected a delivery in August but supplier Sandoz told them the order would not arrive until late November.
Why are infectious disease doctors upset about CSL's handling of the penicillin shortage?
Doctors say earlier notice (in August) would have let them start rationing and preserve existing stocks or look for alternatives. They worry the late warning reduced time to plan and could force suboptimal treatment choices for some patients.
Could the penicillin shortage affect patient care or antibiotic resistance?
According to the article, the federal government says patient care will not be compromised. However infectious disease specialists warn the shortage could lead to substandard care for some patients and force clinicians to use broader‑spectrum antibiotics that encourage the growth of dangerous superbugs.
What explanation did CSL give for the supply delay of penicillin?
A CSL spokeswoman said the company had expected stock to arrive in August but the pharmaceutical company Sandoz informed them the order would not arrive until late November. CSL said it alerted the TGA and some hospitals verbally when it became clear a shortage would occur, but declined to state when those alerts happened.
What are health authorities doing to manage the penicillin shortage?
The Commonwealth's Chief Medical Officer, Professor Chris Baggoley, sent a contingency plan to hospitals to help manage the problem. The TGA was also reported to be trying to find another supplier if necessary. The Department of Health said Professor Baggoley issued advice on alternative antibiotics intended not to promote superbug growth.
Are there broader concerns about drug supply reliability in Australia?
Yes. Infectious disease specialists and Professor Peter Collignon told the article that recent disruptions to other drug supplies (including tuberculosis and malaria treatments) show the government should review systems and ensure Australia has multiple suppliers for crucial drugs like penicillin.
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