Shortage of Amoxicillin felt amid RSV surge

As respiratory illnesses spread rapidly among children across the country, an increased demand for amoxicillin is causing a shortage of the commonly prescribed antibiotic.

Parents filling their kids’ prescriptions may have to try a few pharmacies or end up with a different strength or form than originally prescribed, but amoxicillin in some form is generally still available, pharmacists said. The supply of the liquid version is most strained, along with some chewable tablets.

The flood of demand for the antibiotic reflects a surge in RSV, or respiratory syncytial virus, that is straining pediatric wards at hospitals across the country and in the Detroit area.

Some experts say the pandemic may be partly to blame for the surge, as young children had little exposure to the cold-like virus over the past two years.

The supply strain comes as doctors brace not only for the RSV surge to continue but also for flu and COVID-19 to ramp up.

Though amoxicillin does not treat RSV, flu or COVID-19, it is frequently prescribed for bacterial infections.

Kids with RSV or the flu can develop symptoms that are hard to distinguish from bacterial infections or can contract a bacterial illness secondarily, experts said, sometimes leading doctors to prescribe amoxicillin just in case.

“Health care systems have been dealing with medication shortages continually

throughout the last four to five years, worsened by supply shortages across the country,” said Dr. Matthew Denenberg, system chief, Pediatrics, Corewell Health East, formerly Beaumont Health.

“We have backup plans in place for taking the best possible care of our patients. Amoxicillin is used for various bacterial affections. It is not used to treat RSV and the shortage will not directly affect treatment of the virus,” Denenberg said in an email.

Amoxicillin is commonly used, particularly with children, to treat illnesses

like ear infections, strep throat and urinary tract infections.

Swiss manufacturer Sandoz has hired more workers and added shifts, a spokesperson said, and projects the company will make more than double the amount of amoxicillin next year as it did in 2021. For now, the FDA lists some Sandoz amoxicillin products as unavailable.

A spokesperson for CVS said the chain’s pharmacies have seen isolated shortages of some doses of amoxicillin.

Walgreens also noted the new demand, but a spokesperson said its pharmacies

are keeping up so far.

The shortage isn’t at a crisis level and may be short term, lasting as long as the season of illness does, based on data from manufacturers, said Michael Ganio, senior director for pharmacy practice and quality at the American Society of Health System Pharmacists.

Patients or their parents may be able to ask their doctors to prescribe a different antibiotic if amoxicillin is not available, experts say.