title: Developing a Method for Reporting Patient Harm Due to Antimicrobial Shortages.
abstract: BACKGROUND
  The number of drug shortages in the United States has increased in recent years. While some literature exists on factors that contribute to antimicrobial shortages, the need remains to accurately gage the level of patient harm incurred as a result of realized antimicrobial shortages. Furthermore, current methods of reporting adverse drug events are known to under-report instances of patient harm. We sought to develop an ongoing and accurate method of reporting patient harm due to antimicrobial shortages, which was convenient, anonymous, and allowed clinicians to estimate the causality due to a shortage.
  
  
  METHODS
  We distributed a public SurveyMonkey(®) (SurveyMonkey, Palo Alto, CA, USA) link to gather information regarding institution (for de-duplicating purposes), patient age, sex, antimicrobial product on shortage, type of infection requiring treatment or prophylaxis, adverse event, and patient outcome.
  
  
  RESULTS
  To date complete data were reported on four patients being treated for infections that included Stenotrophomonas maltophilia bacteremia, Pneumocystis jirovecii pneumonia, neonatal sepsis of unknown etiology, and cytomegalovirus colitis. Antimicrobials that were unavailable to patients included sulfamethoxazole-trimethoprim, gentamicin, and foscarnet. Two adverse events (a delay in treatment and an inability to treat with other antimicrobials due to resistance) were attributed with probable causality due to a shortage, while the remaining adverse events (death and an inability to tolerate high oral doses) were attributed to have unlikely and possible causalities due to a shortage, respectively.
  
  
  CONCLUSIONS
  These methods encourage reports of antimicrobial shortage harms.
authors.affiliation: Midwestern University, Chicago College of Pharmacy, Downers Grove, IL, USA.|Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Milena M
authors.initials: MM
authors.lastname: McLaughlin
authors.affiliation: Midwestern University, Chicago College of Pharmacy, Downers Grove, IL, USA.
authors.forename: Erik
authors.initials: E
authors.lastname: Skoglund
authors.affiliation: Midwestern University, Chicago College of Pharmacy, Downers Grove, IL, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Pentoney
authors.affiliation: Midwestern University, Chicago College of Pharmacy, Downers Grove, IL, USA. mscheetz@nmh.org.|Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA. mscheetz@nmh.org.
authors.forename: Marc H
authors.initials: MH
authors.lastname: Scheetz
keywords: Adverse events; Antimicrobials; Drug reporting; Drug shortages; Infectious diseases; Patient outcomes; Survey