An increasing shortage of antibiotics, including some showing success in treating drug-resistant infections, could be increasing the risk of illness and death among patients, a report says.

An analysis of data from the University of Utah Drug Information Service database, a national database of drug shortages, showed 148 antibiotics experienced shortages during the study period of 2001 to 2013, including many gold-standard therapies and drugs being used to treat highly resistant infections, the report shows.

 Almost half of the shortages involved antibiotics used to treat high-risk pathogens, including C. difficile and methicillin-resistant Staphylococcus aureus (MRSA) among others, the paper published in Clinical Infectious Diseases said.

In 2011, C. difficile was blamed for 500,000 infections and almost 30,000 deaths, while MRSA infections strike some 78,000 people a year and can also be fatal, according to the U.S. Centers for Disease Control and Prevention.

"Many of the drug shortages were among the only drugs to treat a particular condition, drugs to treat antibiotic-resistant bacteria and drugs used to treat children," says study leader Dr. Larissa May, an associate professor of emergency medicine at George Washington University in Washington, D.C.

"When these drugs are not available, patients may not get the best care, or even die," she says. "If something isn't done, there may be big impacts on health care."

Reasons for the shortages can vary, she says; there can be problems and delays in manufacturing, or if a drug isn't used very often manufacturers may delay making it or stop altogether, even if the drug is essential to a small number of patients.

Because drug manufacturers aren't required to report such shortages, a lack of a particular drug can catch doctors and hospitals off guard, she says; she suggests the reporting of shortages ought to be made mandatory so medical professional can prepare for them.

There is also a lack of economic incentives to develop new antibiotics, explains Michael Kinch, head of the Center for Research Innovation in Business at Washington University in St. Louis, Mo.

"From a commercial standpoint, you are talking about a low-margin, low-priced product," he says. "If a company has to decide to develop an antibiotic versus a new cancer drug, the obvious choice is to go with the new, more expensive drug."

Developing a new drug is expense, averaging $2.6 billion, pushing drug companies to concentrate their efforts on drugs that will recover those research costs, "and that's not going to be in antibiotics," Kinch says.

He suggests government should take a more active role in making sure there is always an adequate supple of antibiotics.

"Generally, the market does a good job of filling needs. However, in this case the market really is not working," he says. "The federal government needs to get involved, because this is fundamentally a public health issue."

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