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ArticleWellcome open research2025

Responding to and managing antibiotic shortages: a qualitative study with experts and opinion leaders.

Vrinda Nampoothiri, Ritika Kondel Bhandari, Avaneesh Kumar Pandey, Oluchi Mbamalu, Jennifer Cohn, Sanjeev Singh, Marc Mendelson, Nusrat Shafiq, Esmita Charani

Abstract read
In one paragraph

Article in Wellcome open research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

9 authors.

Vrinda NampoothiriDepartment of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Ritika Kondel BhandariClinical Pharmacology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India.
Avaneesh Kumar PandeyClinical Pharmacology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India.
Oluchi MbamaluDivision of Infectious Diseases and HIV Medicine, University of Cape Town Department of Medicine, Groote Schuur Hospital, Observatory, Western Cape, South Africa.
Jennifer CohnGlobal Antibiotic Research and Development Partnership, Geneva, Geneva, Switzerland.
Sanjeev SinghDepartment of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Marc MendelsonDivision of Infectious Diseases and HIV Medicine, University of Cape Town Department of Medicine, Groote Schuur Hospital, Observatory, Western Cape, South Africa.ORCID https://orcid.org/0000-0001-6668-3893
Nusrat ShafiqClinical Pharmacology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India.
Esmita CharaniDivision of Infectious Diseases and HIV Medicine, University of Cape Town Department of Medicine, Groote Schuur Hospital, Observatory, Western Cape, South Africa.ORCID https://orcid.org/0000-0002-5938-1202

Funding

Wellcome Trust
6 · The paper itself

Abstract

Background: We investigated the main drivers for current shortages of licensed antibiotics, existing mitigation strategies undertaken and potential barriers in their implementation through in-depth interviews with experts operating in select regions. Methods: Purposive sampling was used to identify opinion leaders with expertise in managing antibiotic supply chains, access, and shortages between August 2023 and April 2024. Consented participants were interviewed using a semi-structured interview guide developed using the PESTELI (political, economic, sociological, ecological, technological, legal, industry) framework. Data collection and analysis were iterative and recursive, using constant comparison. Results: Participants who were interviewed (n=16) had local, national, and global roles in managing and studying access, supply, and demand chain management from Europe, South Africa, India and USA. Political engagement on antibiotic shortages is reported to facilitate effective mitigation strategies, especially in areas where there is strong evidence of government investment. Legal measures have also been used; for example, pharmacists in the UK being given rights to automatically substitute antibiotics on prescriptions and negotiating with pharmaceutical companies for greater transparency on the challenges in manufacturing. Economic incentives are currently missing and are recognised as being a driver for lack of engagement on this topic from pharmaceutical industry. Greater transparency is required from the pharmaceutical companies on the manufacturing chain issues that may lead to shortages. Technologically there is a major gap in systems to forecast and manage antibiotic shortages. Sociological elements include adopting appropriate communication to not cause panic buying and hoarding by organisations when there is an impending shortage. Legislative changes are linked to the political and economic barriers for cohesive systems to manage the antibiotic manufacture and supply chain in relation to shortages. Conclusion: Currently there are limited interventions to respond to and manage shortages. The antibiotic manufacture and supply chain is complex and under the influence of PESTELI indicators which will need to be understood and mitigated in different contexts and regions.

Indexed as

antibiotic resistanceantibiotic shortagesPESTELI

Identifiers

PMID41623500
PMCPMC12856250

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.