Pharmacists are reporting UK-wide shortages of the antibiotics used to treat strep A, despite the health secretary insisting that the government is “not aware” of a problem.
Demand for penicillin and amoxicillin has increased in recent days as the number of cases of strep A has risen among children in schools. At least nine children have died due to complications from the infection since September. Independent pharmacies say they cannot replenish stocks of the antibiotics because wholesalers say there is no availability.
The health secretary, Steve Barclay, told Times Radio on Wednesday that officials were “not aware of any shortages” and that medicine manufacturers were “required to notify us if there are supply issues, and we have not been notified by them of that”.
Leyla Hannbeck, the chief executive of the Association of Independent Multiple Pharmacies, said pharmacists across the country were reporting that they could not restock many types of antibiotics and were dealing with angry customers who she said had been misled by the health secretary.
“The government can say what they want but we are on the frontline and we know what’s happening,” she said. “I want to make it very clear the frustration among healthcare professionals because we don’t want to let our patients down, we have people coming in, parents, we just need to have better planning. Our hands are very tied, the government has to act now.”
She said she had received reports of patients visiting 12 pharmacies to try to find one of the antibiotics used to treat strep A.
Hannbeck said there was a broader systemic problem of regular drugs shortages, exemplified by the HRT shortage earlier in the year.
She said pharmacies had repeatedly asked the Department of Health and Social Care to bring wholesalers and manufacturers together around a table to discuss how to prevent future shortages, but had been rebuffed.
Her understanding is that manufacturers blame raw materials bottlenecks due to coronavirus lockdowns in east Asia for the shortages.
Dr Andrew Hill, a drugs expert at Liverpool University, said amoxicillin was in shortage worldwide, with health authorities in France, Spain, US, Canada and Australia all reporting lack of supply, after “an increased demand for this drug, given recent waves of different infections, mainly in children”.
Strep A is a common infection in children and most cases are mild or asymptomatic, although it can cause scarlet fever, strep throat, and bacteria can get into the bloodstream and lungs, causing sepsis.
Antibiotic treatment is usually prescribed only in more serious cases owing to concerns around antibiotic resistance. However, recent guidance has asked GPs to be especially vigilant for strep A, which may mean they are more likely to prescribe antibiotics.
Barclay said in areas where there had been a sharp rise in demand, there were “well-established procedures in terms of moving stock around between our wholesale depots”.
He said: “We have a dedicated team permanently in the department who do this day in, day out, and they have reassured me – I checked with them again last night, knowing that I was coming out on the media this morning – and they said they are not aware of any shortages, but sometimes obviously you get the peaks of demand in a particular area and stock has moved around accordingly.”
About five schools in Carmarthenshire, south west Wales, have had outbreaks of strep A with a number of pupils needing hospital treatment The Welsh government and council have highlighted concerns about the shortages of antibiotics.
More than 20 pupils at Brynaman primary, a 300-pupil Welsh medium school near Ammanford, have been infected with two taken to hospital for treatment. One remains in hospital in Cardiff.
Councillor Glynog Davies, the cabinet member for education and a governor at the school, said five schools had been affected in Carmarthenshire. “There are cases in many other counties,” he said, adding: “One worry that has been drawn to my attention is a shortage of antibiotics.”
Eluned Morgan, the Welsh health minister, said: “The increase in demand for antibiotics to treat suspected cases of strep A has led to some pharmacies in Wales experiencing shortages of stock.
“We are working with the UK government medicines supply team and other partners to make sure pharmacies in Wales have the supplies they need.”
Kieran Sharrock, the GP committee acting chair for the British Medical Association, said anxiety over the spread of Strep A and medicine shortages “can cause increased workload and disruption for GPs as they have to find alternative treatment options or prioritise those most in need”.
He said: “While the government insists there are sufficient supplies of antibiotics nationally, this will be little comfort to pharmacists, GPs and patients who are experiencing shortages locally, and therefore those responsible for supply chains must double down on efforts to ensure there are enough medicines to meet demand.”
Dr Zara Aziz, a GP in Bristol, said local pharmacies were running into antibiotic syrup shortages, usually prescribed for throat infections “as demand in general practice for sick kids/worried parents becomes relentless”. Instead GPs were prescribing tablets and capsules and providing guidance on how children could be encouraged to swallow these. She said it was “worrying” if anyone who really needed the antibiotics was unable to get them.
Pharmacist Sri Kanaparthy tweeted a photo of the dashboard he uses to order antibiotics, which appears to show that there is no stock available to order of both penicillin and amoxicillin.
Here is our evidence to show that there is a serious shortage pic.twitter.com/MkSlcwsMWA
— Sri Kanaparthy (@SriKanaparthy) December 7, 2022
A Department of Health and Social Care spokesperson said: “There are antibiotics available to treat strep A and your GP will be able to prescribe the most appropriate treatment.
“Strep A usually causes a mild infection producing sore throats or scarlet fever that can be easily treated with antibiotics. However, it is important that parents are on the lookout for symptoms and see a doctor as quickly as possible so that their child can be treated.
“Make sure you talk to a health professional if your child is showing signs of deteriorating after a bout of scarlet fever, a sore throat, or a respiratory infection.”
