Jun '22 Infectious Disease 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.
 

June 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.

• 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 co-packaged treatments for H. pylori

• Vonoprazan/amoxicillin/clarithromycin (brand name Voquezna "Triple Pak") and vonoprazan/amoxicillin (brand name Voquezna "Dual Pak") for the treatment of H. pylori infection in adults. Vonoprazan is an oral potassium-competitive acid blocker, co-packaged with amoxicillin ± clarithromycin. The recommended oral dosage of the Triple Pak is vonoprazan 20 mg bid + amoxicillin 1000 mg bid + clarithromycin 500 bid, with or without food, for 14 days. The recommended oral dosage of the Dual Pak is vonoprazan 20 mg bid + amoxicillin 1000 mg tid, with or without food, for 14 days. Product launch is expected in the third quarter of 2022.

New Dosage Form of Tecovirimat

• Tecovirimat 200 mg injection (brand name Tpoxx) for the treatment of human smallpox disease caused by variola virus in adults and pediatric patients weighing at least 3 kg. Recommended dosage (for up to 14 days): weight 3 to <35 kg, give 6 mg/kg IV q12h; weight 35 to <120 kg, give 200 mg IV q12h; weight ≥120 kg, give 300 mg IV q12h. Doses should be infused over 6 hours.

Drug Shortages (US)

• Antimicrobial drugs or vaccines in reduced supply or unavailable (as of June 13, 2022) due to increased demand, manufacturing delays, product discontinuation by a specific manufacturer, or unspecified reasons:
  • New on the list since May 7, 2022:
    • None
  • Shortage recently resolved:
    • Acyclovir injection, Amphotericin B injection, Ethambutol tablets
  • 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
      • Cefuroxime 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)
    • Metronidazole injection
    • Nitrofurantoin oral suspension
    • Penicillins:
      • Ampicillin-sulbactam injection
      • Dicloxacillin capsules
      • Piperacillin-tazobactam injection
    • Quinupristin-Dalfopristin 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: 
    • Clotrimazole 10 mg oral troches
  • Antimycobacterial drugs in continued reduced supply: 
    • Rifampin capsules
    • Rifampin injection
    • Rifapentine tablets
  • Antiviral drugs in continued reduced supply: 
    • 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)

• For more detailed information including estimated resupply dates, see https://www.ashp.org/Drug-Shortages/