Influenza and RSV increase the demand for antibiotics and antivirals

Though the shortage of amoxicillin, particularly its liquid and chewable forms, has been frustrating for pharmacists, doctors and parents whose children have become accustomed to the gum and strawberry-flavored variants of the drug, experts say there’s no need to panic: According to the FDA, effective alternatives such as cephalexin and clindamycin remain plentiful

But finding a suitable alternative delays care and can be frustrating. “It’s exhausting looking after a sick child and now you have to get a prescription. But there are alternatives that are appropriate for the age and the indication,” said Dr. Michael Ganio, Senior Director of Pharmaceutical Practice and Quality at the American Society of Health-System Pharmacists

While hundreds of drugs, including chemotherapy drugs and anesthetics, have been in short supply for years, the current shortage of amoxicillin and antiviral drugs is unusual, said Dr. Ganio. He attributed the surge in demand to the rise in respiratory illnesses early this year.

“These are not typical drug shortages associated with manufacturing or supply chain disruptions,” he said. While most drugmakers prepare for seasonal fluctuations, he said, “We don’t use much Tamiflu in the northern hemisphere during the summer and manufacturers plan accordingly. That hit earlier than expected.”

The FDA, which tracks drug shortages on its website, said there is no nationwide shortage of Tamiflu, but that some regions of the country are experiencing 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 shortages underscore the vulnerability of the country’s drug supply chain, particularly for cheap generic drugs like amoxicillin, which are only made by a handful of companies. Experts say the low prices of such drugs discourage investments in sophisticated quality management systems, which can improve manufacturers’ agility in the face of shortages and allow them to ramp up production faster.

One manufacturer, Sandoz, said it is ramping up production to meet increased demand and hopes to double production in the coming months. “We face challenges to manage this surge in demand now that flu season is in full swing,” the company said in a statement.

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