Importance of Maintaining Antibiotic Supply Chains: Effect of Penicillin Shortage on Global Burden of Rheumatic Heart Disease

Document Type

Article

Abstract

Background: Rheumatic heart disease (RHD) is a sequela of a simple Group A streptococcus (GAS) infection. It is estimated that in 2019 the global incidence of RHD was 2.8 million new cases, up from 1.3 million cases in 2017. Our study looks to identify whether the availability and the cost of penicillin has a correlation to the prevalence of RHD.

Methods: Data from the Global Health Data Exchange (GHDx) was queried for incidence, prevalence, deaths, and disability years between the years of 2010-2019. We identified the 25/195 countries with the highest incidence, prevalence, and deaths due to RHD. We then identified the availability and cost of penicillin.

Results: Using the GHDx we identified n= 195 countries in the world with reported data on RHD. We looked at the 25 countries that had the highest overall incidence. Of these countries, 11/25 reported shortage of antibiotics, 4/25 reported no shortage, and 5/25 had no report at all. The median price of penicillin is between $0.13 - $0.28.

Conclusion: The treatment for GAS infection is a simple shot of Benzathine Penicillin G (BPG) which can prevent the development of RHD at a rate of 80%. Decreased availability of Penicillin leads to increased use of other antibiotics; which may be ineffective. A solution we propose is for governments of these countries to incentivize pharmaceutical companies to produce antibiotics such as BPG. In 2018, after the penicillin shortage was partially resolved, the incidence dropped proving that adequate antibiotic supply chains are vital.

First Page

2386

DOI

10.1016/S0735-1097(23)02830-9

Publication Date

3-7-2023

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