Australian parents are struggling to find medicines for their children as cold and flu cases continue to rise this winter, according to health experts and practitioners.
As part of ongoing medicine shortages caused by global supply problems since the Covid pandemic, children’s medicine has become a “hotspot” in the last couple of weeks.
Supplies of children’s antibiotics and painkillers are in particularly short supply. This has led some chemists to ration their supplies, with Chemist Warehouse placing a one box per customer limitation on children’s panadol.
Dr Bruce Willett, the vice-president of the Royal Australian College of General Practitioners, said “these shortages tend to come and go fairly quickly. It’s a bit like a guerrilla campaign … at the moment children’s medicine is a hotspot.
“Particularly some of our oral liquid forms of some antibiotics seems to be the main one that’s having problems at the moment.”
Mazi Rostami, a pharmacist at TerryWhite Chemmart in Elwood in Melbourne, said children’s antibiotics, Panadol, Nurofen drops and chewables had been out of stock for weeks.
Parents had come in distressed after being unable to find these medicines for their children at other nearby chemists as well, Rostami said.
Pranay Nath, a pharmacist at Chemist Warehouse Rocklea in Brisbane, said the only children’s prescription medicine which has been out of stock has been antibiotics, with more children getting sick in winter contributing to demand.
“It’s very unpredictable at the moment,” Nath said, with the shortage ongoing for a few months, “on and off” and customers ordering medicines as soon as they came back into stock.
The government’s medicine regulatory agency, the Therapeutic Goods Administration (TGA), said it was aware of increased demand and intermittent supply of non-prescription children’s painkillers such as ibuprofen and paracetamol, but information from suppliers suggested there are adequate national supplies overall over the coming months.
The TGA said while tablet and capsule antibiotics have stabilised over recent months since shortages emerged at the end of last year, the supply of liquid antibiotics commonly used by children remain ongoing. Some of these shortages extend until early 2024, but alternatives are available, the TGA said.
The TGA introduced a new serious scarcity substitution instrument for children’s antibiotics on 1 August, allowing pharmacists to provide alternative antibiotics, after the first instrument introduced in December last year expired.
Willett said substitutions and alternative agents are available for children’s antibiotics, but negotiating the substitution of the usual antibiotic used, known as first-line antibiotics, with second-line antibiotics, is inconvenient for patients, pharmacists and doctors.
Second-line antibiotics are often not optimal because they can be more expensive, make a small difference in efficacy and side-effect profile and can lead to antimicrobial resistance. Doctors usually prescribe narrow spectrum, as opposed to broad spectrum, antibiotics as a first-line medication because the latter induces antimicrobial resistance, he said.
Antimicrobial resistance, which occurs when bacteria and viruses change to no longer respond to medicines – meaning they become ineffective – is a “constant concern” with antibiotics, Willett said.
Dr Peter Collignon, an expert in antibiotic resistance from the Australian National University’s medical school, said it is a concern if broad spectrum antibiotics have to be used.
“If you don’t have narrow, less expensive antibiotics, the alternative is something with a broader spectrum, which will contribute more to antibiotic resistance in the person and everyone else in the community, and may well have more side effects for the individual like rashes or diarrhoea,” Collignon said.
The government has taken action to address the global supply issues by requiring drug companies to keep stockpiles of medications. However, the requirements only came into effect last month, so stockpiles are still building up, Willett said.
Because of the competitive globalised medication market, drug companies will favour places like the US where they can sell them for more, he said.
He said he would like to see the return of local manufacturing of medications, which has reduced over the last decade.
“As long as we’re at the beck and call of international manufacturers, it’s going to always be difficult to ensure supply of these medications,” Willett said.
• This article was amended on 11 August 2023. An earlier version said that second-line antibiotics could ‘reduce’ antimicrobial resistance. This should have said ‘lead to’.
