CNN
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Shortages of key medicines used to treat common childhood illnesses like the flu., ear infections and sore throats add to the misery of this year’s severe early season of respiratory viruses.
“Right now, we are having a severe drug shortage. There is no Tamiflu for children. There is hardly any Tamiflu for adults. And this is brand name and generic,” said Renae Kraft, a relief pharmacist in Oklahoma City. Also, “when it comes to antibiotics, there aren’t many of them.”
Kraft often works in rural areas of the state, floating between pharmacies when extra help is needed. On Monday he worked in Holdenville, where there are two drug stores: Pruett’s and Walmart. The same wholesaler stocks both stores, so if one pharmacy is out, the other is usually out as well.
Kraft estimates he had 20 people go to Pruett’s to fill prescriptions for Tamiflu on Monday, but he didn’t have any, so he sent them to Walmart, which still had some.
On social media, families say they have searched for hours for oseltamivir, the generic version of Tamiflu and the front-line antibiotics amoxicillin and Augmentin. Inhalers of the drug albuterol, which is used to open airways in the lungs, are also in short supply, according to the American Society of Health System Pharmacists, which maintains a list of drug shortages.
Anyone can report a shortage to the society’s list, and pharmacists at the University of Utah check the information with drug manufacturers.
“In my 25 years as a pediatrician, I’ve never seen anything like it,” said Dr. Stacene Maroushek, a pediatric infectious disease specialist at Hennepin Healthcare in Minnesota. “I’ve seen families that just don’t get a break. They have one viral disease after another. And now there’s the side effect of ear infections and pneumonia that amoxicillin shortages cause.”
The cause of this shortage does not appear to be a manufacturing issue, says Michael Ganio, senior director of pharmaceutical practice and quality for the American Society of Health System Pharmacists.
“This is simply an earlier than expected and higher than usual increase in demand,” he said.
According to the US Centers for Disease Control and Prevention, more than half of US states have “high” or “very high” respiratory virus activity. Most of it is due to the flu, which hit early and hard this year. Respiratory syncytial virus, or RSV, is also playing a role. Nationwide, about 1 in 5 RSV tests came back positive in the past week, a rate much higher than any point in the past two years.
There have been about 8 flu hospitalizations per 100,000 people this season, rates typically seen in December or January. The cumulative hospitalization rate hasn’t been this high at this point in the season in more than a decade.
Assortment of prescriptions for the antiviral Tamiflu is at its highest in 10 years for this time of year, according to GoodRx.com, a company that helps people find discounts on prescription drugs.
People in the US are six times more likely to be taking Tamiflu at this point in the flu season than during the winter of 2019-20, which is the next highest year.
As for the antibiotics amoxicillin and Augmentin, a combination of amoxicillin and clavulanate, an agent that helps protect against antibiotic resistance, it’s not entirely clear why the demand is so high.
The CDC considers these to be first-line therapies for many common childhood ailments, including ear, sinus, and throat infections.
Some viral illnesses, such as influenza, can make the body more vulnerable to secondary bacterial infections that may require treatment with antibiotics.
But these antibiotics have also been inappropriately prescribed when a child’s illness is actually caused by a virus. Antibiotics kill bacteria, but they do nothing to combat viral illnesses.
“Every time respiratory viruses emerge, people start prescribing antibiotics, even inappropriately, and that creates a huge demand. That was not anticipated by the manufacturers of amoxicillin, so it caused a shortage,” said Dr. Amesh Adalja, a senior fellow at the Johns Hopkins Center for Health Security.
Pharmaceutical companies that make generic drugs typically do not stock those drugs on the shelves. Instead, they make drugs based on orders placed earlier in the year. This year’s orders did not anticipate the peak season for respiratory illnesses, some manufacturers said.
In response, they are ramping up production, but it will take some time to get more product in stock.
Drugmaker Teva says it anticipates some backordered strengths of amoxicillin to become available again starting in early December and continuing through the end of February.
Sandoz, which also makes generic amoxicillin, said the shortage was due to many factors. “The combination in rapid succession of the impact of the pandemic and consequent swings in demand, manufacturing capacity constraints, raw material shortages and the current energy crisis means that we are currently facing an exceptionally difficult situation,” the company said. it’s a statement.
Hikma, another amoxicillin maker, said it has adequate supplies to meet orders and is managing its supply to ensure all orders are filled.
“We understand the importance of this drug and are looking at ways to increase production,” a spokesperson said in a statement.
Genentech, which makes Tamiflu, says it has many brand-name antiviral drugs available.
“We have enough supply to meet demand and we are continually evaluating the need to increase production. Tamiflu is also widely available and there are multiple generic manufacturers of oseltamivir. There is sufficient supply of branded Tamiflu,” a company spokesperson said in a statement.
Other companies that make amoxicillin and those that make generic versions of Tamiflu reported they were in short supply and did not respond to CNN’s request for comment.
The US Food and Drug Administration has taken steps to help amid the shortage by providing guidance to pharmacists on how to prepare liquid amoxicillin for children. of versions of pills. Amoxicillin pills for adults are not in short supply, Ganio said.
Although news of this shortage can raise some anxiety, parents should be vigilant but not alarmed, said Brigid Groves, a pharmacist and senior director of practice and professional affairs for the American Pharmacists Association.
The most important thing families can do for a sick loved one is to get tested, he said. Most doctor’s offices and some pharmacies can perform rapid tests to help determine if your symptoms are from a viral or bacterial illness.
“We don’t want to treat someone who has covid with an antibiotic, because it won’t be effective,” Groves said. “And then we also run the risk of creating more resistance in our current bacterial antimicrobial agents.”
A recent study by the Pew Charitable Trusts concluded that approximately 30% of outpatient antibiotic prescriptions for children were inappropriate, either because the drugs were given to treat viral illnesses or because the recommended agent was not used. In addition, the study found that antibiotics increase the risk of C. diff, a bacterial infection that can be life-threatening; allergic reactions; and skin rashes.
“It is important for the family or caregiver to properly assess their loved one to ensure that whatever they are receiving treatment for, they will receive the appropriate therapy,” Groves said. That can be a viral illness or a bacterial infection, or a condition that requires drugs like albuterol for supportive care, making sure the drug is used appropriately for children who are wheezing or having trouble breathing.
Groves also said parents should be aware that it may take a bit of hunting to fill a child’s prescription for Tamiflu or amoxicillin. They may have to drive further or go to a store they are not familiar with.
If all stores in the area are closed, he said, it’s possible to get a prescription for a different antibiotic or antiviral.
“There are options to treat the same infection with a different agent,” he said.
A compounding pharmacy can also mix the medication you need.
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