Some forms of popular antibiotic amoxicillin in short supply, likely due to increased demand

By Jen Christensen, CNN

Amoxicillin, a common antibiotic used to treat a broad range of conditions, is in short supply, according to the US Food and Drug Administration.

The agency lists amoxicillin oral solution in its drug shortage database, which relies on reports from manufacturers. The oral solution is an anti-infective used with pediatric patients.

The FDA told CNN on Friday that it was aware of “some intermittent supply interruptions” in the US and is working with manufacturers to evaluate the supply chain to help prevent or reduce the effects of drug shortages.

The American Society of Health-System Pharmacists, which gets reports about drug shortages from health-care practitioners, patients and caregivers, said Friday that it started hearing about a shortage of amoxicillin tablets and oral solution in some areas about three weeks ago.

Erin Fox, whose team creates the content for the group’s drug shortage website, said it is getting reports that the antibiotic may be available in some areas, but not in some of the more commonly prescribed strengths.

“I think it’s going to be challenging for doctors and prescribers to give their patients a prescription that they’ll then be able to get filled, because pharmacies are going to have a variety of different strengths in stock, and you hate to have that delay of the back and forth, especially for an antibiotic they usually want to get started pretty quick. So I think it’s going to be a frustrating shortage,” said Fox, a senior pharmacy director at University of Utah Health.

Government databases in Ireland, Australia, Malaysia and Romania also reported a lack of availability of the drug due to some manufacturing issues and unexpected demand.

Drugmakers Aurobindo, Rising, Sandoz, Teva and US Antibiotics did not respond to requests for comment.

Some companies say there has been little demand for the drug during the pandemic, when Covid-19 mitigation measures also lowered rates of other infections. Companies make the antibiotic when there is a demand for it, but they need time to catch up when demand increases.

A spokesperson for Hikma said that company is delivering to its customers in full and has adequate supplies to meet its commitments.

“Our number one priority is to honor the commitments we have to our current customers, and allocation allows us to achieve this,” said Steve Weiss, Hikma’s head of communications and corporate affairs. “We understand the importance of this medication and are looking at ways to increase production. “

In the US, the amoxicillin shortage does not seem to follow the usual pattern, according to Michael Ganio, the American Society of Health-System Pharmacists’ senior director for pharmacy practice and quality.

“Generally, what we see in the drug shortages is on the production side. In this case, we don’t have any indication from the manufacturers that they’re having any sort of difficulty with production,” he said. “This one seems to be driven by demand, which is a little unusual. We see increased demand as a cause of a shortage fairly infrequently.”

The US is struggling with an early surge in RSV cases, and although doctors would not use amoxicillin to treat the viral infection, some children can develop secondary bacterial infections that may require antibiotics. It’s also possible that if a doctor can’t narrow down the cause of an infection, they may opt to prescribe an antibiotic.

“It seems like that may be what’s happening right now,” Ganio said.

With a shortage driven by demand, it is possible that one pharmacy will have the drug in stock while others won’t.

Walgreens told CNN it was not experiencing any shortages. CVS and Walmart did not respond to requests for comment.

Fox suggests that someone who gets a prescription for amoxicillin check with the pharmacy first to see if they have the drug in stock at the strength that was prescribed. The health-care provider could also write a prescription for a couple of options. Amoxicillin-clavulante and cefuroxime are also good alternatives, particularly for pediatric bacterial infections.

“My first advice would be, don’t panic,” Fox said. “There is still some amoxicillin. It just might need a quick change of prescription.”

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