4CPS-071 Shortage of drugs era: impact of piperacilin/tazobactam shortage

Background In Spain, in the past 6 months there has been a mean of 0.9 shortages per day. A piperacilin/tazobactam shortage was announced in April 2018 by the Spanish Agency of Medicine and Health Products (AEMPS). In May 2018 the AEMPS offered it as a foreign drug to Spanish hospitals but it ran out quickly. After that no alternative was available until July 2018, when the AEMPS offered it again as foreign drug. However, its defined daily dose (DDD) cost twice more than the national product alternative. At the end of June, the hospital ran out of stock until the end of September when the national product was restored. On the other hand, since April 2014, an Antimicrobial Stewardship Programme (ASP) has been implemented in hospitalisation units (HU). One of this programme’s purposes is to work on the rational use of carbapenems. In this hospital carbapenems DDDs/100 bed days of HU were, in 2016 and 2017, 6.89 and 6.93, respectively. Purpose The aim of this study is to analyse carbapenems exposure during piperacilin/tazobactam shortage in a tertiary care hospital. Material and methods Carbapenems exposure was measured by DDDs/100 bed days 3 months before (April, May and June) and 3 months during the shortage (July, August and September), and furthermore expense variation was calculated. Carbapenems consumption, at HU and intensive care unit (ICU), was calculated. Results During the shortage, carbapenems DDDs/100 bed days increased by 92% for HU and by 143% for ICU. This carbapenems DDDs/100 bed days rise cost an additional €5300. Conclusion These data show the huge impact of the piperacilin/tazobactam shortage in public health and economic resources. The management of shortages should be a public health priority for European health authorities. Also, this situation makes it difficult to get Antimicrobial Stewardship Programme purposes. Ecological impact must be evaluated after this excessive use of carbapenems. References and/or acknowledgements https://www.whocc.no/atc_ddd_index/ No conflict of interest.