While shortages of amoxicillin, especially its liquid and chewable form, have disappointed pharmacists, doctors, and parents whose children are used to chewing gum and strawberry-flavored varieties of the drug, experts say there is no reason to panic: According to the FDA, stocks of effective alternatives such as cephalexin and clindamycin remain in abundance.
But the process of finding a suitable alternative is daunting and can be frustrating. “Caring for a sick child is already hard, and now you still need to find a recipe. But there are age-appropriate and indication-appropriate alternatives available,” said Dr. Michael Ganio, senior director of pharmacy practice and quality at the American Society of Health System Pharmacists.
While hundreds of drugs, including chemotherapy and anesthetics, have been in short supply for years, the current shortage of amoxicillin and antivirals is unusual, Dr. Ganio said. He attributed the spike in demand to an early spike in respiratory illness this year.
“This is not a typical drug shortage due to a disruption in production or supply chain,” he said. While most drug makers are gearing up for seasonal changes, he said: “We don’t use much Tamiflu in the northern hemisphere during the summer, and manufacturers are planning accordingly. It happened earlier than expected.”
The Food and Drug Administration, which monitors drug shortages in his website, said that there was no shortage of Tamiflu in the country, but some regions of the country experienced temporary shortages. There are a number of alternatives to Tamiflu that can prevent the flu and reduce the severity and duration of the illness, but many doctors are unfamiliar with these options, experts say.
The shortage highlights the fragility of the national drug supply chain, especially low-cost generics such as amoxicillin, which are made by just a few companies. Experts say low prices for such medicines discourage investment in sophisticated quality management systems, which can increase manufacturers’ flexibility in the face of shortages and enable them to ramp up production faster.
One manufacturer, Sandoz, said it was ramping up production to meet increased demand and hoped to double production in the coming months. “We are facing challenges to meet this sudden surge in demand now that flu season is in full swing,” the company said in a statement.