Shortage of 'first-line' antibiotic hits as surge in children's respiratory illnesses strains supply

Doctors and pharmacists in Canada are having trouble finding an important antibiotic for treating bacterial infections in children, and some are insisting a surge in respiratory illnesses is contributing to the shortage.

Amoxicillin is one of the most commonly used antibiotics, especially among young patients. But pharmacists and pediatricians told CBC Toronto they are struggling to find the drug.

"We are entering a shortage situation for a number of the different brands of the amoxicillin suspension. It does look like this supply shortage could run into the new year," said Jen Belcher, vice president of the Ontario Pharmacists Association.

According to Health Canada four, companies — Sanis Health Inc., Apotex Inc, GlaxoSmithKline Inc. and Teva Canada Limited — are reporting shortages of various products that contain amoxicillin. The federal agency says eight other manufacturers are not reporting shortages at this time.

In the United States, amoxicillin oral suspension powder is currently in short supply, according to the U.S. Food and Drug Administration. On the administration's website, Amoxicillin manufacturers say "increase in demand" is the reason why supplies are low.

Belcher points to the same issue in Ontario. 

"We're just seeing exceptionally high levels of demand," shhe said.

The shortage comes as Ontario hospitals are seeing much higher numbers of children with respiratory illnesses. Some experts say the surge is likely due to patients' immune systems being under-prepared for exposure to pathogens following widespread COVID-19 isolation and physical distancing requirements. 

"We are seeing a huge surge in children who have communicable infections like colds, coughs and flu and those are those predisposed to bacterial infections," said Dr. Daniel Flanders, a pediatrician and the founder of the Kindercare clinic in Toronto.

Canada is also experiencing a shortage of pediatric pain medication, including children's Tylenol and Advil, a phenomenon experts have linked to supply chain problems, panic buying and the increase is illnesses.

Amoxicillin is the "first line antibiotic" for bacterial infections in children, according to Flanders. He says it's economical and well-tolerated by patients. 

Flanders says that many of his patients' parents are now having to shop around various pharmacies to find one that has the drug in stock.

He says that pharmacists are also strategically rationing supplies and making their own suspensions to meet the need.

"I would say to date we're kind of hobbling along and sort of networking with our colleagues to stay on top of which pharmacies have what. The longer this goes on the harder it's going to be for us to keep it together and I think eventually it'll crumble and there will be people who are truly suffering," Flanders said.