Shortage of streptomycin: time for a change of approach?

摘要

As tuberculosis experts met for the 41st Union World Conference on Lung Health on Nov 11-15, a shortage of one of the first effective antibiotics against Mycobacterium tuberculosis, streptomycin, came to the fore. WHO'S STOP TB partnership estimates that for the next 6 months up to 110000 people in 41 countries will lack access to this antibiotic. At present, 15 countries are out of stock and 11 more are set to run out before supplies can resume. Although combination drug regimens have supplanted streptomycin as the first-line treatment for tuberculosis, it remains an important second-line drug. It is recommended to patients returning to treatment with persistent symptoms after defaulting, or relapsing after apparent cure when the pathogenic strain is unknown. The breakdown in streptomycin supply was precipitated by new Global Drug Facility criteria for quality, which sought to mitigate antimicrobial resistance and toxic effects, but meant that the company that had supplied 80% of streptomycin's active ingredient was unable to meet demand.