Flu and RSV arrive at Christmas, increasing demand for antibiotics and antivirals

Although the shortage of amoxicillin, especially in its liquid and chewable forms, has proven frustrating for pharmacists, doctors and parents whose children have grown accustomed to the strawberry and gum-flavored varieties of the drug, experts say there’s no reason to panic: Supplies of effective alternatives like cephalexin and clindamycin remain plentiful, according to the FDA

But the process of searching for a suitable alternative delays care and can be frustrating. “Taking care of a sick child is already stressful, and now you have to find a prescription on top of it. But there are alternatives available that are age and indication appropriate,” said Dr. Michael Ganio, senior director of pharmacy practice and quality for the American Society of Health System Pharmacists.

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

“This is not your typical drug shortage, which is associated with manufacturing or supply chain disruptions,” he said. While most drug manufacturers prepare for seasonal variations, he said: “We don’t use much Tamiflu in the Northern Hemisphere during the summer, and manufacturers plan accordingly. This has come sooner than expected.”

The FDA, which tracks drug shortages in your website, said there was no national shortage of Tamiflu, but that some regions of the country were experiencing temporary shortages. There are a number of alternatives to Tamiflu, which can prevent the flu and reduce the severity and duration of illness, but many doctors aren’t familiar with those options, experts say.

The shortages highlight the fragility of the country’s drug supply chain, especially for cheap generics like amoxicillin, which are made by only a handful of companies. Experts say the low prices for such drugs discourage investment in sophisticated quality management systems, which can improve manufacturers’ agility in the event of shortages and allow them to ramp up production more quickly.

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