The Public Health Agency of Canada (the Agency) has been made aware of a national cefixime shortage which is expected to last until September 2015. There is only one Canadian supplier of cefixime at present; however, the shortage is a result of a problem with a third party manufacturer. Gonococcal infections have shown progressive resistance to penicillin, tetracycline, and quinolones; third generation oral and injectable cephalosporins are the last remaining first-line treatments. As one of the recommended treatments for gonococcal infections, the shortage of cefixime hinders our efforts to control this infection. The Agency is working closely with Health Canada regulators to develop options to mitigate the shortage in the longer term. As a short-term mitigation strategy, please consider conserving available stock of cefixime for patients with gonococcal infection in whom ceftriaxone is contraindicated (or in settings where its use is not possible), and using alternative treatments instead of cefixime for non-gonococcal infections. In consultation with the Expert Working Group for the Canadian STI Guidelines, the Agency is providing health care professionals with the following interim recommendations for the treatment and follow-up of gonococcal infections until the shortage is resolved.
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