Local pediatrician discusses amoxicillin shortage

CHICAGO — Pharmacies across the nation, including Chicagoland, are grappling with a shortage of the popular antibiotic, amoxicillin.

The drug is one of the most commonly prescribed antibiotics, especially for children who have an ear infection or pneumonia.

In late October, the U.S. Food and Drug Administration (FDA) issued an alert about supply shortages of the “powder for suspension” form of the antibiotic which is mixed with water to create an oral solution for pediatric patients.

Health experts believe the shortage may be due to the surge in upper respiratory infections and supply chain issues.

“Some of it is potentially manufacturing issue hold overs from the pandemic that are still becoming a problem, in addition to the significant rise in viral illnesses that’s happened over the last month with RSV, flu and COVID. The increase in those viruses then increases your risk of developing bacterial infections that we would use amoxicillin to treat,” said Dr. Hollis Redmon, a pediatrician with Advocate Childrens Medical Group Naperville and Lombard  Pediatrics. “So, things like ear infections and pneumonia, where in the pediatric world amoxicillin is typically our go to medication and manufacturers aren’t able to keep up with the demand for the medication.”

The American Society of Hospital Pharmacists says there are now shortages of other versions of amoxicillin listing oral capsules, tablets and chewable tablets in short supply.

This is the time of year doctors start to see more ear infections and cases of pneumonia in children, and in a majority of those cases amoxicillin would be prescribed. 

But Dr. Redmon said due to this year’s shortage, pediatricians are being told to default to alternative medications to treat a patient with bacterial pneumonia. If the child is over the age of two with an ear infection — pediatricians are urged not to give their pint-sized patient an antibiotic.

“We are being informed by Advocate Aurora Health System to default to different types of medications as opposed to hunting for different pharmacies that may have stock. We do have other medication options; Augmentin is our secondary option that’s used more commonly,” said Dr. Redmon. “It’s an amoxicillin derivative with an additional ingredient in it, so it is a stronger medication but still one that’s totally appropriate to treat your infection and pneumonia and things like that.”

Redmond adds pediatricians also have a family of antibiotics called Cephalosporins that they can prescribe as an alternative for amoxicillin as manufacturers scramble to get supply back on track.

 “Within the over two-year-old population it is not unreasonable to sometimes wait before prescribing an antibiotic for something like an ear infection. For example, there’s an option to choose, watch, and wait instead. Where you treat the patients pain as opposed to immediately prescribing an antibiotic, so we are being encouraged to try that in our older children,” she said. “Children under two do need to be treated for an ear infection. But children over two can maybe wait it out if they can. Your body will fight it off eventually. Especially if the ear infection is being treated by a virus and you don’t necessarily need an antibiotic to treat that infection. So, we are hoping to try to reduce our need for amoxicillin as well, encouraging families to try to hold off before starting an antibiotic.”