Drug shortages lead to interrupted TB treatment in a third of UK health centres

11 June 2011 - London - Nearly two thirds of treatment centres in the UK have reported difficulty obtaining drugs to treat tuberculosis (TB), causing a third of centres to interrupt treatment at least once, according to a new study in the International Journal of Tuberculosis and Lung Disease.

The authors also say 26% of centres have used unlicensed, variable-strength and locally prepared suspensions for treating children with TB.

The results suggest that the UK does not currently have an effective drug supply and management system and that it is at risk of creating home-grown drug resistance, the authors argue. They suggest that a branch of the National Health Service should provide strategic national guidance to ensure a consistent and reliable supply of anti-TB drugs.

Although the United Kingdom has a low TB burden, more than 7000 new cases of active TB were reported in 2009 and there has been no decline in the number of cases since 1990. This trend is the reverse of what is happening in many other industrialized countries, where rates are falling.

The study was based on a questionnaire sent to pharmacists at 168 treatment centres across the UK, which the authors estimate manage approximately 60% of all TB cases in the UK.

Of the 77 treatment centres that responded, 63% reported difficulties in obtaining anti-TB drugs. Consequently, 27% had to interrupt the prescribed treatment regimen at least once and 19% had to alter the types of drugs used.

Of 55 centres treating multidrug-resistant tuberculosis, 36% reported difficulties obtaining second-line drugs, 16% had to interrupt the prescribed treatment regimen at least once and 5% had to alter the types of drugs used.

The authors of the study are: Dr Toby Capstick of the Pharmacy Department, St James’s University Hospital, Leeds; Debbie Laycock of the All-Party Parliamentary Group on Global Tuberculosis and Dr Marc Lipman of the Department of Thoracic Medicine, Royal Free Hospital, London.