Western Pa. medical experts keep watch on amoxicillin shortage

A shortage of the broad-range antibiotic amoxicillin is being felt in Western Pennsylvania, and experts are tracking how it will impact local care.

The U.S. Food and Drug Administration last month announced a shortage of the oral suspension of the drug, which is used to fight bacteria in a wide range of applications. The oral suspension is most often prescribed in pediatric medicine.

Representatives from Allegheny Health Network, UPMC and Excela Health all confirmed they are keeping an eye on the shortage. Excela Health says it has already run out of the liquid form.

“We have been out of the liquid amoxicillin product for around a month or so,” said Excela’s director of pharmacy, Michael Sekho. “In general the pharmacy has seen a rise in Augmentin liquid use as a substitute. Also, anyone who can take oral tablets or capsules is converted to them as soon as possible.”

Laura Mark, vice president of pharmacy for AHN, said her organization is keeping tabs on supply chain problems — the suspected cause of the amoxicillin shortage — through the American Society of Health System Pharmacists. She said AHN also is looking at using alternatives to amoxicillin, such as Augmentin, which includes amoxicillin and clavulanate, and is an antibiotic used to treat bacterial infections such as sinusitis, pneumonia and bronchitis.

“Right now, we are seeing some shortages but it’s nothing we can’t manage,” Mark said. “It’s something we’re watching, and making sure we have quantities on-hand.”

UPMC said it “continually monitors supplies and works ahead of industrywide shortages so that our patients aren’t impacted,” in a statement.

“We have alternatives for amoxicillin, whether from another manufacturer or in another form of the medication,” UPMC said in a statement. “If necessary, our pharmacists and physicians can evaluate alternative selections to ensure safe and effective treatments for our patients.”

Sekhon said amoxicillin might be in short supply because of the current spate of RSV cases.

Respiratory syncytial virus, or RSV, is a common respiratory virus that can be serious for infants and older adults. RSV, which has seen a substantial uptick in diagnosis recently, is the most common cause of bronchiolitis, or inflammation of the small airways in the lung, and pneumonia, or infection of the lungs, in children younger than 1 in the U.S.

“The rise in RSV illnesses is having an impact of the availability of amoxicillin because it is being prescribed inappropriately,” Sekhon said. “Antibiotics are not helpful in RSV as it is a virus, although practitioners continue to prescribe them. Using antibiotics for viral infections leads to worsening shortages as well as contributes to antibiotic resistance.”

Representatives from CVS and Walgreens said their respective pharmacies could not provide information about availability of amoxicillin based on a regional location.

“There is an industry-wide supplier shortage of certain doses of amoxicillin, and we are working with manufacturers to replenish supply as quickly as possible,” said Matt Blanchette, senior manager of Retail Communications for CVS Pharmacy.

“Across the country, even though the demand is up, we’re still able to meet that demand,” said Fraser Engerman, a Walgreens spokesperson.

Rite Aid could not be reached Tuesday for comment.

Jack Moschgat, co-owner of Mainline Pharmacy, an independent pharmacy with 11 locations across Pennsylvania, said he’s definitely seen a shortage of amoxicillin in recent months.

“We have been fortunate to keep it in stock for the most part. I guess that is one of the advantages to being a small business is you can proactively try to get ahead of it, and make sure you have it in stock for your patients,” Moschgat said at a Penn Township location. “We aren’t that concerned, just because we kind of got ahead of it, and we’re pretty well stocked. It was concerning at the beginning because people weren’t able to get it.”

All of Mainline Pharmacy’s stores have the drug and are fully stocked, Moschgat said. Patients who would usually fill their prescriptions at other pharmacy networks have recently been coming to Mainline, he added.

“We’ve been getting patients who aren’t even usually coming here, if they’re going to Rite Aid or Giant Eagle, if they don’t have it, then the doctor will send them here instead,” he said. “We did send out a fax to a lot of the pediatricians to let them know that if someone needs it, our stores have it.”