Wholesalers update GPs on antibiotic shortages

Information provided to GPs by pharmaceutical wholesalers confirms severe antibiotic shortages, it has been reported.

A spreadsheet available to general practices, and seen by The Pharmacist's sister publication Pulse, with information from the three main national wholesalers on antibiotic availability, shows that a range of antibiotic preparations and dosages are out of stock, it has been suggested.

The list showed that Phoenix, Alliance Healthcare and AAH wholesalers had no stock of amoxicillin 250mg/5ml suspension or both 125mg/5ml or 250mg/5ml Penicillin V suspension. Only one wholesaler had stocks of sugar free suspension for 125mg Penicillin V liquid.

This comes as the specialist pharmacy service have issued advice on using solid dosage form antibiotics in children.

If children are able to swallow whole tablets, that is the preferred option but Penicillin V tablets can be crushed or dispersed in water where needed, the guidance states.

But 250mg Penicillin tablets were also out of stock in the spreadsheet seen by Pulse, which is being shared with GPs to provide a ‘a day-by-day insight into what is available at the main wholesalers for pharmacies to order which may help inform what to prescribe’.

Pulse has reported that one ICB is advising GPs consider reverting to paper prescriptions due to potential antibiotics prescriptions.

Yet the Government has downplayed reports of supply problems with the Prime Minister Rishi Sunak stating in Parliament there were no shortages.

Pharmacists had said they were having difficulty accessing stock with some lines seemingly completely unavailable.

A Department of Health and Social Care spokesperson said: ‘There is no supplier shortage of antibiotics available to treat Strep A. As the Secretary of State said, we sometimes have surges for products and increased demand means some pharmacies are having difficulties obtaining certain antibiotics.

‘We are working urgently with manufactures and wholesalers to explore what can be done to expedite deliveries and bring forward stock they have to help ensure it gets to where it’s needed, to meet demand as quickly as possible and support access to these vital medicines.’

Pharmacists have raised concerns about problems with antibiotic supply, demanding greater guidance from government on the developing issue.

Pharmacist and England chair of the RPS, Thorrun Govind, told The Pharmacist that community pharmacists and practice pharmacists could work together to support patients, for instance by sharing information about which formulations were in stock where, moving medicines between branches and recommending alternative prescriptions or formulations.

GP consultations for scarlet fever and disease notifications are rising more steeply than expected for this time of year as are cases of invasive group A streptococcus, although less pronounced, the UK Health Security Agency (UKHSA) has warned.

Updated figures from the UKHSA released on 8 December show so far this season (from 12 September to 4 December) there have been 6,601 notifications of scarlet fever. This compares to a total of 2,538 at the same point in the year during the last comparably high season in 2017 to 2018.

There have also been 85 cases of invasive group A streptococcal infections in children aged 1 to 4 compared to 194 across the whole of the last comparably high season in 2017 to 2018, the UKHSA said.

Since September there have now been 13 deaths in children under 15, the Agency confirmed.

Yesterday, the World Health Organization (WHO) highlighted increasing antimicrobial resistance, based on data from 87 countries worldwide.

A version of this story was initially published by Pulse