Drug shortages in the United States are common, but their effect on patient care and outcomes has rarely been reported. This cohort study evaluated whether a national shortage of norepinephrine in the United States in 2011 was associated with increased mortality among adults with septic shock.

Among patients with septic shock in US hospitals affected by the 2011 norepinephrine shortage, the most commonly administered alternative vasopressor was phenylephrine. Patients admitted to these hospitals during times of shortage had higher in-hospital mortality.

Among 27,835 patients with septic shock in 26 hospitals that demonstrated at least 1 quarter of norepinephrine shortage in 2011, norepinephrine use among cohort patients declined from 77% of patients before the shortage to a low of 55.7% in the second quarter of 2011; phenylephrine was the most frequently used alternative vasopressor during this time.

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