Topline
Liquid amoxicillin has been in a shortage for almost a year, and as the colder months bring a rise in common childhood infections—like strep throat and ear infections—parents may have to find alternatives as shelves could stay bare.
Close-up of a bottle of oral suspension Amoxicillin antibiotic, often used for pediatric patients.
Key Facts
Amoxicillin powder has been in a supply shortage since October 2022, according to the Food and Drug Administration’s drug shortage list.
The powder is typically mixed with water to form the liquid version of the drug, though other foods, like chocolate syrup or sugar, can be added to help with the taste.
The pill version of the drug is not affected by the shortage, but kids three years and younger typically can’t swallow pills, so they depend on the liquid versions of medications.
Amoxicillin is a popular antibiotic used to treat bacterial infections, like pneumonia and dental abscesses, and is commonly prescribed for children to treat infections like strep throat, ear infections and chest infections—it is not available over the counter.
Novartis AG, one of the biggest manufacturers of liquid amoxicillin, told Bloomberg the shortage was due to “significant” demand for the drug, and Hikma Pharmaceuticals—another top manufacturer—told the publication its products were “on allocation,” meaning it’s limiting new orders.
The American Academy of Pediatrics recommends using amoxicillin clavulanate, intramuscular ceftriaxone, penicillin VK, intramuscular penicillin G benzathine or cephalexin as alternatives to liquid amoxicillin.
Big Number
211.1 million. That’s how many antibiotics were prescribed in 2021, according to the Centers for Disease Control and Prevention. That’s equivalent to 636 antibiotic prescriptions per 1,000 people. Amoxicillin was prescribed 42.9 million times, making it the most prescribed antibiotic in the country.
Key Background
Though antibiotics don’t treat colds, the flu, respiratory syncytial virus (RSV)or Covid, children may develop secondary bacterial infections from these infections, which may result in amoxicillin being prescribed, the Washington Post reports. As the winter months approach, cases of respiratory viruses are expected to increase. Covid, the flu and RSVare the three viruses that make up the deadly so-called tripledemic, which resulted in between 300,000 and 650,000 flu-related hospitalizations, 100,000 to 200,000 RSV-related hospitalizations and around 700,000 Covid-related hospitalizations during the 2022-2023 tripledemic season. Young children are the “most vulnerable” to the tripledemic, family physician Mike Sevilla told Fortune. A study published in the journal of the American Academy of Pediatrics looked at the clinical effects of last winter’s amoxicillin shortage and found after the drug was declared in a shortage, prescriptions dropped by 90%. Doctors began prescribing cefdinir and augmentin as alternatives, which can play a part in antibiotic resistance and cause harsher side effects, like ulcers, loss of body heat, continuous vomiting or the yellowing of the eyes or skin.
Surprising Fact
Amoxicillin and other antibiotics are 42% more likely to be in a shortage compared to other drugs, according to a recent report by U.S. Pharmacopeia.
Tangent
Last year’s tripledemic caused shortages of children’s pain relief medications, like children’s Tylenol, Advil and Motrin. Because children are the most susceptible to the tripledemic, demand for their medication skyrocketed, resulting in the shortage. Retailers like CVS and Walgreens placed limits on the amount of medication customers could buy: CVS had a two-product limit for in-store and online, and Walgreens had a six-product online limit.
Further Reading
Here’s Why There Is A Shortage For Children’s Tylenol, Advil And Motrin—And What To Do About It (Forbes)
Flu Vaccine Cut Hospitalizations In South America—Here’s What That Means For The U.S. (Forbes)
FDA Approves New Covid Vaccines To Target Latest Strains (Forbes)
CDC Panel Recommends RSV Vaccine For Some Expectant Mothers (Forbes)