Pharmacies, hospitals and manufacturers are reporting a shortage of the popular antibiotic amoxicillin, a dilemma experts attribute to the approaching cold and flu season and an increasing number of respiratory syncytial virus cases, known as RSV.
The Food and Drug Administration issued notices of the shortage on Monday that involved the five main manufacturers of the drug typically used to treat bacterial infections like pneumonia and bronchitis in children.
One company, Hikma Pharmaceuticals, said in an email statement that it is continuing to allocate adequate supplies of amoxicillin to its customers while looking for ways to increase its production.
Increased demand for the antibiotic is causing the shortage, not supply chain issues related to the manufacturing, transportation and availability of raw materials, said Michael Ganio, senior director of pharmacy practice and quality with the American Society of Health-System Pharmacists.
“While there may be a shortage on the shelves, it should not last long as each of the manufacturers can continue to make products,” Ganio said.
The society began hearing reports of an amoxicillin shortage in mid-October, just as healthcare professionals nationally were reporting a rise in RSV cases, he said.
Although amoxicillin is not a proper treatment for RSV, clinicians can prescribe it for bacterial infections that may develop along with or after the viral illness.
Some manufacturers anticipate inventory levels to normalize by the end of November or early 2023, Ganio said.
“In the short term, it will be inconvenient for some patients and providers,” said Erin Fox, senior pharmacy director at University of Utah Health. “Providers might want to check in with the pharmacy that they're sending their prescription to, to make sure that that strength is available. Otherwise, they might need to adjust their prescription.”
Providers and pharmacists can also try calling wholesalers and manufacturing companies to see if the amoxicillin can be sent directly to local pharmacies, said David Rosen, a partner and public policy lawyer with Foley & Lardner.
Depending on the specific clinical scenario, as well as the condition of the patient, there are alternatives such as ampicillin, or medications from stronger class of antibiotics called cephalosporins, he said. But this may be a less favorable option to some.
“Everybody is used to using amoxicillin,” Rosen said. “It's inexpensive and it's well tolerated. That's why people like it.”
The low supply of amoxicillin is just one of more than 260 active drug shortages the society has been tracking this year, Ganio said, many of which are “much more concerning both in severity and scope.”