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CDC updates ECPs on EzriCare Artificial Tears discontinuation

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The Centers for Disease Control and Prevention (CDC) has issued a Health Alert Network (HAN) Advisory for the use of EzriCare Artificial Tears for dry eye treatment following reported infections across the country.

I need some background.

The CDC stated last month that it was investigating cases of Verona Integron‐mediated Metallo‐β‐lactamase (VIM)‐ and Guiana‐Extended Spectrum‐β‐Lactamase (GES)‐ producing carbapenem‐resistant Pseudomonas aeruginosa (VIM‐GES‐CRPA) in clusters within multiple states that were linked to various infection sites (inclusive of ocular tissues).

Read our previous coverage.

When, where, and how were they identified?

VIM‐GES‐CRPA was reported in 55 patient cases identified from May 17, 2022 to January 19, 2023, in 12 states: California, Colorado, Connecticut, Florida, New Jersey, New York, New Mexico, Nevada, Texas, Utah, Washington, and Wisconsin.

Isolates were identified from clinical cultures of several specimens collected, including of the cornea, urine, blood, and rectal swabs.

Is it just EzriCare Artificial Tears?

No. Patients reported infections involving over 10 different artificial tears brands. However, EzriCare’s preservative-free product (carboxymethylcellulose sodium 10 mg) was used by the majority of patients across four healthcare facilities.

Additional recommendations include to not use Delsam Pharma’s artificial tears products.

Laboratory testing identified a presence of VIM-GES-CRPA in opened bottles of the tears; further analysis identified a match to the outbreak strain in two states.

What symptoms did patients report?

The CDC reported permanent vision loss as a result of ocular infection, hospitalization, as well as the death of one patient (from a bloodborne infection).

So what is the CDC recommending?

The CDC stated that any clinicians and patients should immediately stop using EzriCare Artificial Tears pending additional guidance from the CDC and FDA.