April ID Update

Sanford Guide ID Update features current developments in infectious diseases, curated by the Sanford Guide Editorial Board. Links marked with an asterisk (*) provide details to Web Edition subscribers, while all other links are universal. To sign up for ID updates to your inbox, register here.

April 2022

SARS-CoV-2 / COVID-19

Sanford Guide SARS-CoV-2 / COVID-19 material is freely available to all for the course of the pandemic.

  • April 5: Sotrovimab is no longer authorized to treat COVID-19 in any US region due to increases in the proportion of cases caused by the BA.2 sub-variant.
  • March 30: The US FDA authorizes a second booster dose of either the Pfizer-BioNTech or Moderna vaccine for older people and certain immunocompromised individuals, as follows:
    • A second dose of either vaccine to Individuals ≥50 years of age, ≥4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine.
    • A second booster dose of the Pfizer-BioNTech vaccine may be administered to individuals ≥12 years of age with certain kinds of immunocompromise, ≥4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine. These are people who have undergone solid organ transplantation, or who are living with conditions that are considered to have an equivalent level of immunocompromise.
    • A second booster dose of the Moderna vaccine may be administered ≥4 months after the first booster dose of any authorized or approved COVID-19 vaccine to individuals ≥18 years of age with the same certain kinds of immunocompromise.
  • COVID-19 vaccination in cancer patients: preliminary recommendations from NCCN here.
  • Currently authorized vaccines. See COVID-19 Prevention for table summarizing use and data.
  • ESCMID COVID-19 living guidelines: drug treatment and clinical management (Clin Microbiol Infect 2021 Nov 22 [online ahead of print]). Available at PMC.
  • Guidelines on COVID-19 diagnosis, serology, treatment and management, and infection prevention: IDSA and NIH.
  • Living WHO guideline on drugs for COVID-19 (BMJ 2021;375:n2936).
  • Living WHO guideline on drugs to prevent COVID-19 (BMJ 2021;372:n526). Available here.
  • Living WHO guideline on prophylaxis against COVID-19 (BMJ 2021;373:n949). Available at PMC.
  • Management of hospitalized adults with COVID-19: a European Respiratory Society living guideline (Eur Respir J 2021;57(4):2100048). Available at PMC.

New Dosage Form of Triumeq

  • Triumeq* PD (abacavir 60 mg, dolutegravir 5 mg, lamivudine 30 mg) tablets for oral suspension, for treatment of HIV-1 infection in pediatric patients weighing 10 to <25 kg. Not recommended in patients weighing ≥25 kg. The two dosage forms of Triumeq (tablets, PD tablets for oral suspension) must not be interchanged on a mg-for-mg basis due to differing pharmacokinetic profiles of the dolutegravir component.

Drug Shortages (US)

  • Antimicrobial drugs or vaccines in reduced supply or unavailable (as of April 11, 2022) due to increased demand, manufacturing delays, product discontinuation by a specific manufacturer, or unspecified reasons:
    • New on the list since March 7, 2022:
      • Quinupristin-Dalfopristin injection
      • Rifampin capsules
    • Shortage recently resolved:
      • Hepatitis B vaccine recombinant
      • Neomycin and Polymyxin B sulfates and Dexamethasone ophthalmic ointment
      • Posaconazole injection
    • Antibacterial and antimycobacterial drugs in continued reduced supply:
      • Aminoglycosides:
        • Amikacin injection
        • Gentamicin injection
        • Gentamicin sulfate 3% ophthalmic ointment
        • Neomycin tablets
        • Tobramycin injection
      • Carbapenems:
        • Meropenem injection
      • Cephalosporins:
        • Cefazolin injection
        • Cefepime injection
        • Cefixime capsules
        • Cefotaxime injection (FDA is allowing temporary importation of product from SteriMax in Canada, in conjunction with Provepharm Life Solutions and its distributor Direct Success. Click here for details),
        • Ceftazidime injection
      • Clindamycin injection
      • Doxycycline oral suspension
      • Fluoroquinolones:
        • Ciprofloxacin 0.3% ophthalmic solution
        • Gemifloxacin tablets
      • Glycopeptides, glycolipopeptides, lipopeptides:
        • Vancomycin injection
      • Macrolides/azalides:
        • Azithromycin ophthalmic solution 1% (unavailable)
      • Methenamine hippurate tablets
      • Metronidazole injection
      • Nitrofurantoin oral suspension
      • Penicillins:
        • Ampicillin-sulbactam injection
        • Dicloxacillin capsules
        • Piperacillin-tazobactam injection
      • Topical (miscellaneous) antibacterials:
        • Bacitracin ophthalmic ointment
        • Neomycin and Polymyxin B sulfates GU irrigant
        • Sulfacetamide 10%/Prednisolone 0.2% ophthalmic ointment (unavailable)
        • Sulfanilamide 15% vaginal cream (unavailable)
    • Antifungal drugs in continued reduced supply:
      • Amphotericin B injection
      • Clotrimazole 10 mg oral troches
    • Antimycobacterial drugs in continued reduced supply:
      • Ethambutol tablets
      • Rifampin injection
      • Rifapentine tablets
    • Antiviral drugs in continued reduced supply:
      • Acyclovir injection
      • Tocilizumab injection
    • Vaccines in continued reduced supply:
      • None
  • Antimicrobial drugs recently discontinued: 
    • Mupirocin calcium 2% cream (Bactroban [GSK], June 2020)
    • Bacitracin injection (February 2020)
    • Interferon alfa-2b (Intron A, October 2019)
    • Mupirocin calcium 2% nasal ointment (Bactroban Nasal [GSK], August 2019)