Eye drops linked to death and vision loss among some are recalled

The maker of a brand of over-the-counter eye drops said it was recalling the product, EzriCare Artificial Tears, after it was linked to a drug-resistant strain of bacteria that killed at least one person and lost of vision in another five. .

The Centers for Disease Control and Prevention has advised people stop using the eye drops as the agency investigates an outbreak of a strain of pseudomonas aeruginosa bacteria, which can cause infections in the blood, lungs and other parts of the body. This strain of the bacteria had never been identified in the United States before the current outbreak and is resistant to a class of antibiotics called carbapenems, which are generally considered a last resort.

The strain of the bacteria had been found in 55 people in 12 states as of Tuesday. the CDC said. The agency said the infections had caused one death, vision loss in five of the 11 people with eye infections and some hospitalizations.

Global Pharma, the Indian company that makes EzriCare eye drops, said it was withdrawing the eye drops “out of an abundance of caution.”

“Global Pharma is fully cooperating with US federal authorities and is continuing to investigate this matter, but to date we have not determined whether our manufacturing facility is the source of the contamination,” the company said in an emailed statement. .

Most people affected by the outbreak used artificial tears before their infections, the CDC said. They had reported using more than 10 brands of artificial tears and some patients used more than one, but EzriCare Artificial Tears is the most common brand, the agency said.

The CDC said it had found the drug-resistant strain of bacteria in opened vials of EzriCare eye drops collected from patients with and without eye infections. The agency is testing unopened bottles to determine if contamination occurred during the manufacturing process.

The strain of the bacteria was found in people from California, Colorado, Connecticut, Florida, New Jersey, New Mexico, New York, Nevada, Texas, Utah, Washington and Wisconsin between May 2022 and January, according to the CDC. Of those 55 cases, 35 were linked to four groups of health care facilities, the agency said.

The CDC said that people who have used EzriCare Artificial Tears and who have signs of an eye infection should seek medical attention immediately. Symptoms may include yellow, green, or clear discharge from the eye, redness of the eye or eyelid, increased sensitivity to light, and eye pain or discomfort.

Dr. Thomas L. Steinemann, a spokesman for the American Academy of Ophthalmology, said people need not worry too much about using other types of eye drops.

“We use them for tears, we use them for antibiotics, we use them to treat glaucoma.” said Dr. Steinemann. “We use eye drop bottles every day, and I think for the vast majority of eye drop bottle users there is no cause for alarm.”

Dr. Steinemann, an ophthalmologist at MetroHealth Medical Center in Cleveland, noted that the CDC report said that EzriCare artificial tears were preservative-free, meaning that if they are contaminated, they have nothing to prevent the growth of bacteria.

He said doctors often recommend preservative-free artificial tears to patients if they use them more than four times a day because preservatives can worsen eye irritation. He said he had only heard of preservative-free eye drops that were available in single-use vials that cannot be closed and reused later.

“The thing that stood out to me the most when I read the CDC report is that, at least for EzriCare, these products are dispensed in what we call multi-dose bottles, which means that people are reusing the bottle,” said Dr. Steinemann. “But the bottle has no preservatives, which I think could set the stage for contamination or bacterial overgrowth in the bottle.”

When people use any kind of eye drops, Dr. Steinemann said, they should wash their hands, close the bottle after use, and not touch the tip, because that could make the drops non-sterile. “Don’t touch the bottle with your eye, your face or your nose,” he said.

EzriCare, a New Jersey-based pharmaceutical company, said in a statement on Wednesday that it did not manufacture the eye drops and was only involved in designing the product label and marketing it to customers.

EzriCare said it was first informed of the CDC investigation on January 20 and “immediately took action to stop any further distribution or sale of EzriCare Artificial Tears.” The company said it had also been trying to contact customers to tell them to stop using the eye drops.

Public health officials warned that more must be done globally to stop the spread of drug-resistant infections, which occur when bacteria and fungi evolve to outsmart the antibiotics and antifungal drugs that have been developed to destroy them. The more antibiotics and antifungal drugs are given to people and livestock, the more likely resistance will develop, health officials said.

Nearly 30,000 people in the United States died in 2020 from drug-resistant infections, according to a CDC analysis, up 15 percent from 2019. The increase was driven primarily by the coronavirus, which in the early days of the pandemic was a mystery to medical professionals. Many turned to antibiotics to try to treat the disease before vaccines and other treatments were available.

Every year, more than 700,000 people around the world die from drug-resistant infections. The United Nations warned in 2019 that without concerted action, these infections could kill 10 million people annually by 2050 and trigger a global economic crisis.