Eight serious shortage protocols (SSPs) for phenoxymethylpenicillin V (Pen V) that were due to expire yesterday have been extended until the end of February.

Two antibiotics, azithromycin and clarithromycin, have also been removed from the list of medicines that can be supplied as an alternative under five of the Pen V SSPs.

Instead, only amoxicillin, flucloxacillin, cefalexin or co-amoxiclav can be supplied as an alternative to phenoxymethylpenicillin 250mg tablets, 250mg/5ml oral solution and 250mg/5ml oral solution sugar free, as well as 125mg/5ml oral solution and 125mg/5ml oral solution sugar free, under SSP043 – SSP047. The alternatives should be supplied in that order of priority.

However, for a prescribed duration longer than 10 days, erythromycin would be the preferred substitution.

The alternatives that should be considered are outlined in a flowchart published by the Royal Pharmaceutical Society (RPS), which was updated yesterday.

Last week, two new SSPs were issued for HRT products amid ‘significant ongoing disruption’ to supply.

Antibiotics supply issues in December led to calls for medicines supply reform.

‘HRT and antibiotics are the most visible examples of a wider problem with medicines supply which needs to be addressed’ said NPA’s chief executive Mark Lyonette at the time.