In an update released on July 8, 2016, the Centers for Disease Control and Prevention (CDC) recommended against using oral liquid docusate for patients because it was linked an outbreak of infections caused by Burkholderia cepacia complex. As of July 18, 2016, 49 confirmed cases have been confirmed in five different states. Oral liquid docusate is a stool softener product that’s often prescribed to patients undergoing treatment for cancer, particularly so in this population as opioid-induced constipation is a known side effect for which prophylactic management is critical.

The CDC reported that two unused oral liquid docusate products provided by the affected hospitals tested positive for the Burkholderia cepacia complex. The U.S. Food and Drug Administration (FDA) is also testing a number of oral liquid docusate products to determine whether they are epidemiologically linked to the infection-causing complex. 

If stool softening products must be prescribed, the CDC recommends using alternative medications. The FDA has issued a voluntary recall of certain liquid docusate products, although the extent is still unknown. According to the CDC website, “The FDA and CDC continue to recommend that clinicians and patients not use any liquid docusate sodium product as a stool softener or for any other medical purpose.” 

Any provider that identifies the Burkholderia cepacia complex in any of the liquid docusate products should save the products for examination by the CDC. Moreover, any cases should be reported to public health authorities immediately. 

If you have questions about the outbreak or handling of liquid docusate products, contact the CDC at haioutbreak@cdc.gov

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