Antibiotic Shortage Looms as Cold and Flu Season Approach

An antibiotic commonly used by children during cold and flu season to stave off bacterial infections is still in shortage as America heads into fall.

Amoxicillin is the most prescribed antibiotic to children in the United States. Its liquid formulation is a common go-to for doctors treating children with bacterial infections that commonly occur during the winter months, such as strep throat, sinusitis, pneumonia and other respiratory infections.

However, it has remained on the Food and Drug Administration’s list of drugs in shortage since last fall, when an overwhelming surge of flu and respiratory syncytial virus (RSV) led to subsequent bacterial infections in millions of children.

Producing the liquid formulation requires amoxicillin powder, which is what has been in limited supply since October of last year. The powder is available through some of the companies that manufacture it, but the FDA report suggests that its supply is limited and that it is on allocation, meaning that it is being equally distributed among pharmacies and hospitals that need it the most as a way to preserve inventory.

What is causing the amoxicillin shortage?

Only one company reporting shortages on the FDA’s list offered an explanation for why the drug is in limited supply. Teva Pharmaceuticals — an Israeli company that manufactures many generic drugs used in the U.S.  — blames an increase in demand.

Antibiotic prescriptions have seen a significant increase in recent years, even before the pandemic started. Between 2019 and 2020, antibiotic prescriptions rose by 54% in the U.S., according to a February 2023 study.

COVID exacerbated the issue of overprescribing, even though COVID is a viral illness that cannot be treated with antibiotics. That same 2023 study revealed that between 2020 and 2021, up to 55% of COVID outpatients were prescribed antibiotics, despite them not having any signs of a secondary infection that would require them.

Improving antibiotic prescribing is considered a “national priority” by the Centers for Disease Control and Prevention, which is why it is so important for providers to determine whether a patient’s symptoms are rooted in something that is viral versus bacterial.

Will the shortage affect the drug’s availability this winter?

So far, the FDA has not issued any warning that the drug will be unavailable in the coming months. However, in a statement made last year when news of the shortage came to light, the FDA said that there was an “urgent need” to increase the supply of these products.