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Alert Date: 
Tuesday, November 3, 2020 - 4:00pm

TO: Medical Officers of Health and Associate Medical Officers of Health

RE: Erythromycin ophthalmic ointment shortage

We have recently received correspondence regarding the ongoing national shortage of erythromycin ophthalmic ointment, indicated for the prophylaxis of ophthalmia neonatorum. A similar communication was sent out in March 2019 about a shortage of this product at that time as well.

There is a current shortage of erythromycin ophthalmic ointment (1gm packaging size) in Canada. Two suppliers are reporting that product will return to market on January 15, 2021 and March 31, 2021.There is no active shortage report for the 3.5g product.

The Ministry of Health will keep monitoring the supply and will provide updates as they become available. We encourage hospitals to share locally with other hospitals, to help address these acute supply requirements and to contact their LHIN Drug Shortages Lead in order to facilitate this process.

The ministry recognizes the impact of drug shortages on patients, health care professionals and the health care system, and is working with stakeholders throughout the supply chain to better prevent, mitigate and communicate shortages. Ministry staff are in regular contact with manufacturers, regions, hospitals, group purchasing organizations, health care associations / organizations and the Provincial/Territorial Drug Shortages Task Team to identify products that may be at risk of shortages.

In early 2019 and again recently we have engaged the Provincial Council for Child and Maternal Health (PCMCH) to leverage their expertise on provincial supports for the shortage. At this time PCMCH advises that there is no recommended safe alternative medication to be used prophylactically for newborns instead of erythromycin. Therefore, it is recommended that the supply of erythromycin be monitored closely and, if adequate supplies are not available, administration be based on the attending health care professional’s assessment of the situation. Attached to this letter are the algorithms developed by PCMCH’s Maternal-Neonatal Committee and London Health Sciences Centre for screening and response to lab results. These algorithms may be used by health care professionals to support their assessment and decision making. The algorithms can also be downloaded from PCMCH’s website at the following link:

Additionally, in order to support newborn primary care, facilities should include a note in the newborn health record provided to parents indicating whether erythromycin ophthalmic ointment was administered or not. Parents and all neonatal healthcare providers should also be made aware of the symptoms of ophthalmia neonatorum and advised to monitor for these symptoms within the first four weeks of life. They are to seek medical treatment at any signs of infection.

The ministry will provide updates as further information becomes available. We would also like to remind all healthcare professionals that once the supply of erythromycin is returned to normal stock levels, routine administration of the ophthalmic prophylaxis to the eyes of newborns should continue as required under Regulation 557 Communicable Diseases – General under the Health Promotion and Protection Act.

We request that you share the information in this memo with hospitals and other health system partners (e.g. primary and emergency care; midwives) in your jurisdiction.

Thank you for your assistance.

David C. Williams, MD, MHSc, FRCPC
hief Medical Officer of Health

c: Jackie Hubbert, Interim Executive Director, PCMCH