Along with medication, Jarrett Bauder has spent several weeks dispensing bad news to some of his patients — the cure they need might not be available.
Bauder, a pharmacist at the independent Uptown Pharmacy in Westerville, is dealing with a shortage of amoxicillin, a frequently prescribed antibiotic.
The shortage was first reported to the Food and Drug Administration on Oct. 28, which Bauder said lines up with his difficulty trying to stock amoxicillin. Since then, the pharmacy has only intermittently been able to order more of the drug, he said.
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In the meantime, Bauder has been left scrambling to get alternative prescription medication for patients. While the shortage has made more work for Bauder and other pharmacists, he said it’s more frustrating for patients, who just want to feel better.
“We try to be as proactive as we can,” he said. “If we see a script before a person comes in, then we try to take care of it before someone shows up standing at the counter with disappointment.”
It’s not just local pharmacies that have struggled to keep amoxicillin in stock. Pharmacy chains across the country have also been helping patients navigate the shortage.
CVS, the largest pharmacy in the country, told The Dispatch that some of its stores have temporarily run out of the drug. If amoxicillin is out of stock at one location, CVS is usually able to help patients find it at another store or determine the best alternative antibiotic, spokesman Matt Blanchette said.
As the shortage continues, the State of Ohio Board of Pharmacy is looking at ways it can help to alleviate the lack of the drug, said spokesman Cameron McNamee. The state board also issued guidance this month stating that pharmacies could “compound” amoxicillin, meaning pharmacists can combine it with other drugs or dilute it.
It’s unclear when the shortage will end, but the supply of amoxicillin is expected to improve in December, said Don Bennett, interim executive director of the Ohio Pharmacists Association, an advocacy group and trade organization for pharmacists in the Buckeye State.
The drug is typically used to treat ear and sinus infections and things like streptococcal pharyngitis, which is otherwise known as strep throat.
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The amoxicillin shortage followed a widespread spike in cases of seasonal influenza and respiratory syncytial virus (RSV) among children. Although amoxicillin isn’t used to treat the flu or RSV, Bennett said the diseases are likely still the cause for a rise in demand for the drug.
“A lot of times, prescribers are concerned about (kids) developing a secondary infection … and they’re being exposed to more bugs than they’ve been exposed to the last few years during the (COVID-19) pandemic,” Bennett said.
The lack of amoxicillin has forced Columbus-area doctors to change the way they’re treating patients.
OhioHealth’s Dr. Jennifer Middleton said she’s rarely prescribing the drug right now because she knows she’ll likely just have to write another prescription.
Amoxicillin is so widely prescribed because it’s safe, effective and has few side effects, said Middleton, who is also director of the family medicine residency program at OhioHealth’s Riverside Methodist Hospital. The drug is also considered more palatable than other antibiotics, which Middleton said is helpful when trying to get kids to take medicine.
Luckily, Middleton said, there are other antibiotics doctors can prescribe. But a few have some downsides.
Penicillin is one alternative, though Middleton said it tastes terrible. Other “powerhouse antibiotics” can cause gastrointestinal issues or other adverse reactions that amoxicillin doesn’t cause, Middleton said.
At this point, though, Middleton said she doesn’t really have a choice but to turn to other antibiotics.
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“In the last couple of weeks we’ve had so many prescriptions bounce back to us that we started prescribing alternatives,” Middleton said. “They’re all reasonable choices … But it will not be long before I test those waters again.”
The amoxicillin shortage comes in the wake of the ongoing COVID-19 pandemic, which upended supply chains and caused a lack of other vital supplies, such as baby formula. As is the case with baby formula, just a few manufacturers produce amoxicillin.
The drug has been around for so long that generic versions of it are produced. The existence of generic amoxicillin means the drug is a cheaper antibiotic treatment and pharmaceutical companies don’t make much money off of it, both Bennett and Bauder said.
Still, Bauder said he’s surprised that a drug that’s become such a staple in every doctor’s arsenal for treating infection has been in short supply for nearly a month now. For every patient’s sake, he said he hopes supply starts to trickle back in sooner than later.
“It’s one of those medications that’s been around for forever and is used so readily,” Bauder said. “I never thought I’d see this, or at least not with amoxicillin.”