Top 5 Takeaways

  1. Recurrent Drug Shortages: The U.S., particularly California, has faced recurring shortages of first- and second-line TB drugs, impacting treatment regimens.
  2. High Priority Concern: California TB programs rated the stabilization of TB drug supplies as a high priority, with high case-count programs giving it a higher importance rating.
  3. Impact on Treatment: Drug supply interruptions led to delayed treatment initiations, changes in treatment regimens, and in some cases, negative patient outcomes.
  4. Survey Insights: The survey, including 89% of California TB programs, revealed that 64% experienced delays or unavailability of first-line TB drugs.
  5. Proactive Measures: In response to these challenges, California established a centralized buffer supply of TB drugs to mitigate the impact of future shortages.

Original Article Author and Citation

Corresponding Author

Scott A. Nabity,

Suggested Citation

Nabity SA, Agraz-Lara R, Bravo A, et al. Notes from the Field: Supply Interruptions of First- and Second-Line Oral Drugs to Treat Tuberculosis During the Previous 12 Months — California, January–March, 2023. MMWR Morb Mortal Wkly Rep 2024;72:1390–1391. DOI:


The study highlights the ongoing issue of TB drug shortages in the U.S., focusing on California’s experience. California, responsible for about one-fifth of all U.S. TB cases, has seen interruptions in the supply of crucial TB drugs like RIF, RPT, and INH. This has affected TB treatment and control programs throughout the state.


A REDCap survey was distributed to TB controllers and program managers across California’s 61 TB programs. The survey assessed the impact of TB drug shortages, focusing on the availability of first- and second-line oral TB drugs and the prioritization of stabilizing drug supplies.


The findings underscore the significant impact of TB drug supply disruptions on treatment protocols and patient outcomes in California. High case-count programs experienced more severe impacts, necessitating changes in TB disease and LTBI treatment regimens.


To ensure effective TB treatment and progress towards TB elimination, California has established a centralized buffer supply of TB drugs. This proactive approach aims to counteract the negative effects of TB drug shortages and maintain consistent treatment standards.


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