Drug shortages threaten treatment of sexually transmitted infections

Antibiotic shortage: “We can only cover 50 percent of demand”

Currently, Germany is experiencing a bottleneck for important medications for Treatment sexually transmitted diseases. According to a joint Press release the Association of Outpatient Physicians for Infectious Diseases and HIVmedicine (dagnä), the German AIDS Aid (DAH) and the Association of HIV-Competent Pharmacies (DAHKA) no longer have sufficient supplies of the antibiotics doxycycline and azithromycin. This leads to restrictions in the treatment of infectious diseases such as chlamydia, gonorrhea and syphilis.

The chairman of the board of DAHKA, Erik Tenberken, states that "it is estimated that only 50 percent of the demand for both active ingredients" can be covered. Delivery bottlenecks affect almost all pharmacies, although officially only four manufacturers have reported these bottlenecks to the Federal Institute for drug and Medical Devices (BfArM). According to Tenberken, however, no manufacturer is supplying sufficient quantities any more. The current situation means that stocks have to be used up and remaining stocks have to be scraped together, which is not sustainable in the long term.

The broad-spectrum antibiotic doxycycline is used against numerous bacterial Infections and is particularly indispensable in the treatment of sexually transmitted diseases. It is the common treatment for chlamydia and is used in certain cases of syphilis infections. Azithromycin is the drug of choice for mycoplasma infections and, despite increasing resistance, can also be used in the treatment of gonorrhea and chlamydia.

The chairman of the board of dagnä, Dr. Heiko Karcher, points out the great dangers of inadequate supplies. For people who are allergic to penicillin, doxycycline is often the only alternative for syphilis infection, while for chlamydia, the use of gyrase inhibitors, which have serious side effects, must be considered. The supply bottlenecks make it difficult to provide the best possible treatment and unreasonably limit the scope for doctors, which puts patients' health at risk.

As early as the beginning of 2024, there was a massive shortage of the drug combination emtricitabine/tenofovir disoproxil, which is used to prevent and treat HIV. Now, for the second time in a year, there are not enough active ingredients to treat sexually transmitted infections. The dagnä, DAHKA and DAH see this as a scandal and believe that the causes of the current supply difficulties are the same as for emtricitabine/tenofovir disoproxil. It is regrettable that politicians and manufacturers are apparently not addressing the systemic problems that lead to supply bottlenecks.

These problems include inadequate reporting procedures for shortages, a lack of transparency and the concentration of only a few suppliers on the market, most of which produce outside Europe. Even small disruptions in the supply chain can lead to serious shortages. The German discount pricing policy may be contributing to the fact that more and more manufacturers are disappearing from the German market.

Politicians are called upon to act decisively. Measures taken so far at national and European level are not sufficient to solve the problems. Diversification of supply chains, a sustainable strengthening of the production of medicines and active ingredients in Europe and effective measures to ensure adequate stocks are urgently needed. In addition, the mechanisms for pricing medicines in Germany must be reconsidered. The current situation is no longer acceptable and patients have a right to the most effective and best therapy. Emergency solutions should not have to be accepted.