Pharmacies across the United States are reporting shortages of one of the most widely used antibiotics, raising concerns that the medication will be in short supply for the upcoming winter season.
Independent pharmacy owners in Kansas, Georgia and New York confirmed to NBC News that supplies of amoxicillin — commonly prescribed to treat a variety of bacterial infections including ear infections, pneumonia and bronchitis — have been dwindling for weeks. In some cases, drug wholesalers are limiting how much of the medication pharmacies can purchase at one time, likely to avoid running out of them.
“The scary part is, we’re coming into the time of the year where you have the greatest need,” said Hugh Chancy, owner of Chancy Drugs, which has six locations in southern Georgia.
Three key amoxicillin manufacturers — Hikma Pharmaceuticals, headquartered in the United Kingdom; Sandoz, based in Switzerland; and Teva Pharmaceutical Industries Ltd., headquartered in Israel — are reporting shortages of the antibiotic, according to the American Society of Health-System Pharmacists, which maintains a database of drug shortages.
The products affected include chewable tablets, capsules and powder for an oral liquid or “suspension” that is typically prescribed to children. Because amoxicillin is an antibiotic, it is not used to treat infections caused by viruses, such as Covid, the flu or RSV (respiratory syncytial virus).
It’s not clear what is causing the shortage, or how long it could last.
Steven Weiss, a spokesperson for Hikma, said in an email statement that the company is managing distribution to meet its existing supply commitments.
“We are continuing to deliver in full nationally and have adequate supplies to meet our agreed upon commitments with current customers,” he said. “We understand the importance of this medication and are looking at ways to increase production.”
Sandoz and Teva did not immediately respond to requests for comment. Representatives from three of the largest drug wholesalers in the U.S., AmerisourceBergen, McKesson Corp., and Cardinal Health, also did not respond to requests for comment.
Pharmacists said they are worried if the shortage lingers through the winter, when infections can surge and antibiotic use typically increases.
“I am extremely concerned,” said Brian Caswell, owner of Wolkar Drug in Baxter Springs, Kansas. “Amoxicillin just being the No. 1 utilized antibiotic does cause some concern.”
Caswell, who said his pharmacy serves a community of up to 10,000 people in southeastern Kansas, said orders of the pediatric suspension, in particular, are being limited to one bottle per pharmacy per day.
“That doesn’t cut it very well,” he said. “So we’re going to be ordering one bottle every day, whether we need it or not, to just try to stock up, because we don’t know how long this situation is going to last.”
A representative for CVS said its network of pharmacies across the country have not been widely affected.
“There is not a widespread shortage of Amoxicillin. A few stores have seen isolated supplier product shortages of certain doses of the medication,” Matt Blanchette, a spokesperson for CVS, said in an emailed statement. “We’re working with manufacturers to replenish supply as quickly as possible.”
The U.S. Food and Drug Administration does not currently list amoxicillin as being in short supply in its database of drug shortages and discontinuations. The agency considers the market covered if at least one manufacturer can account for total market demand, even if some manufacturers do not have all products available.
Jim McKinney, a spokesperson for the FDA, said in an emailed statement that the agency is “aware of some intermittent supply interruptions of amoxicillin products in the U.S, and are currently working with the approved manufacturers.”
The FDA works to prevent drug shortages, he added. “However, there are a number of factors that can cause or contribute to drug shortages that are out of the FDA’s control. Drug Shortages can occur for many reasons, including manufacturing and quality problems, delays, and discontinuations.”
In Georgia, Chancy said he has not been able to order the 400 milligram dose of the oral suspension for several weeks. He said pharmacists will often work with doctors to find suitable alternatives, in the event that a prescribed drug is unavailable.
But sometimes, “this is the antibiotic they prefer,” said Chancy, who serves as he president of the National Community Pharmacists Association. “And that kind of puts the patients in a bad spot.”
Steve Moore, owner of Condo Pharmacy in Plattsburgh, New York, reported similar issues obtaining supplies of the oral liquid for children. He said supplies of amoxicillin have been inconsistent since early this month.
“We have enough to meet our anticipated usage for the next couple of weeks,” he said. “We typically try to stock about a month’s worth of generics at a time. I believe that we’re OK for the time being, but until we hear whether or not this is going to be a long-term thing or a short-term thing, it’ll be hard to say for sure.”