national amoxicillin shortage

A national shortage of the commonly used antibiotic amoxicillin has been making news since December, leaving many parents concerned about whether they or their sick children will receive the medication they need to beat bouts of strep or other infections. Most local pharmacies are able to supply amoxicillin, but we asked our “Ask a Pediatrician” columnist Dr. Susanna Block to shed light on this issue, explain what they can do if they are affected by the shortage and otherwise reassure them. Here’s what she said:

My child has a sore throat. Should I be concerned they won’t get medication they need?

Dr. Susanna Block: I’d love to just scroll back and talk about sore throats and what needs to be treated and what doesn’t. Having a sore throat is incredibly common, but about 30% of sore throats for kids aged 5 to 15 are from a bacteria called strep (Streptococcus). If you have strep throat, which is a sore throat from the strep infection, that means you need to be treated with antibiotics. It’s important to know that you can have sore throats for many other reasons. Those that are not strep do not require antibiotics. Only strep requires antibiotics — if you know that you have strep throat because you have the clinical symptoms specific to strep.

What are those symptoms?

Dr. Block: Strep throat infection looks like this: Sudden onset of a fever, headache, sore throat, abdominal pain, or rash. When you look in your throat, it’s bright red, you can see mucus, you can see fluffy infiltrate, and you can see big, swollen lymph nodes.

If you have a sore throat because you’ve got a stuffy nose or a cough or watery eyes, that’s a sore throat from another reason, most likely viral, not strep.

Ok, I’m pretty sure my child has strep. What should I do?

Dr. Block: If you are concerned that your child has strep, it’s important to go in to your provider and be tested. There are several different tests that we can do. But the most common is a rapid antigen test. It can be done in the office, and you should get the results within 45 minutes. It’s important to have this test because then you know what you’re dealing with, and you can treat it appropriately.

Why does strep require antibiotics?

Dr. Block: If you have a sore throat and your strep test is negative, you can feel very confident that you have a sore throat for another reason and you don’t need antibiotics. But if it’s positive, you do need antibiotics. Antibiotics are helpful because it decreases the length of time you’re going to feel terrible. It decreases the chance that you’re going to pass strep along to somebody else. And it decreases the chance that you’re going to have any of the complications from having strep. So definitely worth getting treated.

How do you treat step?

Dr. Block: Usually we offer people treatment from an antibiotic that’s in the penicillin family. Amoxicillin is our go-to favorite thing for children because it’s liquid. It can be in a liquid or pill form. It’s really well tolerated and it does the trick.

What is the ongoing concern with antibiotic availability?

Dr. Block: Some places are noting that there’s a shortage of amoxicillin. The second way that we treat strep, typically for people that just hate taking medicine or for one reason or another just aren’t going to be able to complete a 10-day course of amoxicillin, is by using a single shot antibiotic called Bicillan. Both approaches, oral or shot, are good. The challenge we have been hearing nationally is that some places are having a shortage of both. We haven’t actually seen that in our area. At Kaiser Permanente we have both of those medications available. It has not been a problem for us.

What if our pharmacy can’t fill my child’s prescription for amoxicillin?

Dr. Block: If somebody is running into a problem where they’ve been given a prescription and they cannot get it filled, there’s a couple of things to do. First remember that it’s important to get the antibiotics you need. If the pharmacist isn’t able to fill it because of the shortage, they will be able to offer you a different medication that’s also effective. It might take a little time, they might need to call the provider and get a new prescription. But I would encourage parents to get that started.

What I worry about is if people can’t find the medicine that they need, they leave the pharmacy and then just don’t get treated. That can be unsafe.

So, the alternative medications to treat strep will work?

Dr. Block: I can say with 100% assurance that there are alternatives. Think about this, some people are allergic to penicillin but still need to be treated with an antibiotic. They will be offered alternative medication. If amoxicillan or the single shot Bicillin aren’t available, or if you are allergic to those medications, the pharmacists can work with your provider to give you an alternative.