Alternatives are available as the shortage of Amoxicillin stretches

As the season for respiratory diseases arrived, a shortage of amoxicillin is experienced due to heightened demand, as per FDA and multiple manufacturers. However, numerous alternative antibiotics for it exist on the market.

According to Michael Ganio, the senior director of Pharmacy, Practice, and Quality at the American Society of Health-System Pharmacists (ASHP), ASHP started to receive reports pointing towards a shortage in October. Shortly after, AHSP and FDA posted a bulletin in which the products affected were listed.

Arrive Health, a healthcare technology company analyzed the rising demand for amoxicillin. Around 7 million transactions are run by the company monthly across the nation. Just over 800,000 amoxicillin suspension transactions were inspected by Arrive Health, which accounted for 0.41 to just below 1% of the total transactions in a month. However, this number rose to 1.41%, equating to 24.52% of the transactions of kids between 0 and 2 years of age. This number again rose 1.7% of total transactions by mid-November.

A clinical pharmacist at Michigan Medicine, Samuel L. Aitken expressed concern over the possibility that viral diseases could be the reason for amoxicillin being overprescribed. He went on to say, “A very, very small minority, maybe 1% or 2% of children with RSV being treated out of the hospital, will have a bacterial infection, so there are a lot of children being treated for potential infections that they very likely don’t have. The downstream consequence of this, assuming the bad RSV season continues throughout the winter potentially alongside influenza and COVID, is that amoxicillin supplies may run dry and we won’t have it available when it is truly needed.”

To counter this shortage, a few manufacturers applied ceilings to how much amoxicillin a pharmacy can buy at once. One way to counter the shortage is to coordinate with the prescribers and look for a suitable substitute treatment.

Dr. Ganio stated that the shortage could extend into 2023 and is largely dependent on the growth pace of youth respiratory infections. However, he believes it is manageable because of the alternates that can be used. According to him, ASHP is looking at over 260 drug scarcities in the States and most of them are less controllable than amoxicillin.

However, complete dependence on substitute antibiotics could end up in secondary shortages. Dr. Aitken stated that there is no clear best way to deal with such shortages and every pharmacy and hospital will have to make their own choices and decisions regarding their patient count, supplies, and historic use.

Health systems can better cater to drug shortages compared to pharmacies because of a greater stock and the ability to affect prescriptions directly. Dr. Aitken noted that as the shortages extend, both are affected the same. He also said that overstocking is not a long-term solution.

He went on to say that the pharmacists should be ready to answer questions from the patients about amoxicillin substitutes while further adding that it is of utmost importance that respiratory viral diseases are not habitually treated with antibiotics unless there is a high probability of a connected bacterial infection.

Also read, Antivirals and Antiobics Shortage Makes Respiratory Virus Season Worse