Around Halloween, some manufacturers began reporting shortages in liquid (pediatric) formulations of amoxicillin, an antibiotic used for everything from sore throats to ear infections in children.
In recent weeks, shortages of other antibiotics have emerged, primarily for pediatric formulations, such as oseltamivir (Tamiflu) and some formulations of albuterol, used to treat asthma and wheezing.
Some doctors are sending patients home with printed versions of various different antibiotic prescriptions in case the first one is out of stock.
According to the website of the American Society of Health-System Pharmacists, there is no explicit reason or anticipated solution for the shortage of many of these medications.
But what is happening then?
The first bet is that this shortage is partly due to demand. The United States has seen an unprecedented number of cases of the respiratory viruses RSV and influenza, and these viral illnesses are often complicated by overlapping bacterial infections.
Added to this, healthcare professionals have the terrible habit of prescribing antibiotics when they are not indicated. Antibiotics treat specific bacterial infections but do nothing against a virus and can do more harm than good when prescribed inappropriately.
But the problem is bigger than prescribing practices and increased demand. It also involves much more than just pediatric medications. According to the page of the Foods and Drugs Administration (FDA), there are currently over 120 medications that are either unavailable or in shortage in the United States.
This medication supply problem is not new. The FDA has been working on this issue for years, having created the “Drug Shortage Team” in 1999. Despite efforts to address the causes of the problem over the past two decades, the country still has a dysfunctional and opaque medical supply chain. There is still no easy way to ramp up production to meet the excess demand (which is the case now). Limited profits, particularly for low-cost medications like amoxicillin, do not encourage producers to do better.
When first-line medications are unavailable, doctors opt for second-line ones, but this can bring other types of problems, such as people on Medicaid having more restrictive coverage for second-line medications; nursing homes and prisons not having the financial means to hire new suppliers; children needing precise dosages, among others.
The answer to the problem is clearly not to stockpile antibiotics as we did with hand sanitizer, but to advocate for and create better systems – and hold both government and private companies accountable for doing so.
In the meantime, this winter, the best thing to do is not to get sick. Get the flu vaccine and the bivalent Covid-19 booster. If you feel unwell, wear a mask when around others and always wash your hands.
Source: CNN