Three more children have died from strep A, it has emerged, and pharmacists in the UK have been told they can supply alternative antibiotics to those originally prescribed, in a bid to ease shortages of certain forms of penicillin.
The UK Health Security Agency (UKHSA) data shows at least 19 children have now died across the UK, while there are 7,750 cases of scarlet fever so far this season. This is more than treble the 2,538 at the same point in the year during the last comparably high season in 2017 to 2018.
However, the rise in notifications came at a different point that year. In 2017 to 2018, there were 30,768 scarlet fever notifications overall.
The Department of Health and Social Care (DHSC) has issued serious shortage protocols (SSPs) for three penicillin medicines amid increased demand for the antibiotics.
Pharmacists and GPs in the UK have faced serious difficulties in securing supplies of penicillin and amoxycillin, antibiotics used to treat infections including strep A. As a result, parents have reported having to visit a string of pharmacies to obtain medicines prescribed for their sick children, while the price of some antibiotics has risen sharply – a situation pharmacists say has left them facing losses.
Steve Barclay, the health secretary, previously said there was no shortage of antibiotics and stock could be moved around if areas were experiencing problems with supply.
However, on Monday the DHSC, which Barclay oversees, issued a supply warning for certain antibiotics used for the treatment of infections such as strep A.
On Wednesday Prof Susan Hopkins, the chief medical adviser at the UKHSA, told a webinar arranged by the Royal Society of Medicine that there had been a substantial increase in demand for some antibiotics.
“I’ve been told in the last few days that we’re using five times more penicillin than we were using three weeks ago,” she said, adding that while “there may be some behind-the-back-of-doors profiteering” it would not affect patients.
On Wednesday it was announced that the Competition and Markets Authority would look into the rising costs of antibiotics.
The SSPs remove the need for a patient to return to their prescriber to get a new prescription should a particular medication be unavailable. Instead, pharmacists can legally issue a specified alternative.
That, it is hoped, will make it easier for patients to access the medication they need, while saving time for GP practices.
The new SSPs, which have been classed as active until 31 January, apply to three medicines: phenoxymethylpenicillin 250mg/5ml oral solution sugar-free, phenoxymethylpenicillin 250mg/5ml oral solution and phenoxymethylpenicillin 125mg/5ml oral solution sugar-free.
According to the DHSC, there are nine other SSPs currently active, many of which are hormone replacement therapy drugs.
The health minister Will Quince said: “The increased demand for the antibiotics prescribed to treat strep A has meant some pharmacists have been unable to supply the medicine shown on the prescription.
“These serious shortage protocols will allow pharmacists to supply an alternative form of penicillin, which will make things easier for them, patients, and GPs.
“We are taking decisive action to address these temporary issues and improve access to these medicines by continuing to work with manufacturers and wholesalers to speed up deliveries, bring forward stock they have to help ensure it gets to where it’s needed, and boost supply to meet demand as quickly as possible.”
Speaking on Wednesday, Hopkins added a “deep dive” was under way into those who had been severely unwell with strep A.
“We do know that, for example, about one-third of the invasive cases have had another respiratory virus detected at the same time,” she said, noting that perhaps the co-infection meant the bacteria were more likely to go into the lungs and cause a severe problem. But she added: “That’s speculation at the moment.”
