Amid winter illnesses, shortage of often-used medication

A national shortage of one of the most commonly used medications could be affecting local hospitals and doctors’ offices this season, according to health officials.

The Food and Drug Administration listed a shortage of some forms of the antibiotic amoxicillin in late October. The antibiotic is widely used, especially in pediatric medicine, used to treat ear infections, bronchitis and other chest infections. Doctors prescribe it in four different forms — capsule, tablet, chewable tablet and liquid.

The FDA website shows that pharmaceutical manufacturers list “demand increase for drug,” as a reason for the shortage.

This shortage comes at a time when the chest infection respiratory syncytial virus is on the rise in children. RSV is a common respiratory virus that usually causes mild, cold-like symptoms in infants and young children. Adults can get it too, but typically they barely notice the symptoms.

“RSV is a very common virus in children,” Dr. Sehar Ejaz, the interim pediatric chairman for Nassau University Medical Center said. “Almost all the children under age 2 at some point in their young life get it.”

The uptick of RSV comes after a time when children have been sheltered for the past couple of years due to the coronavirus pandemic. Usually only infants and young babies would catch RSV, but now, since children are back in school for the first time after being kept home, older children, like 4- to 5-year-olds, are catching it too.

“It was good that they were protected for the past two years, but now there’s a lot of outbreaks in day cares and schools,” Ejaz said. “The virus usually occurs late fall and goes to early spring, and we see it peak from December to February but this year we’re seeing it a little bit earlier.”

Typically, if a child has RSV, antibiotics wouldn’t be prescribed because the virus tends to go away within five to seven days. The antibiotics are used more for bacterial infections, according to Dr. Ejaz. But, if RSV causes the child to have a bacterial infection, amoxicillin is the first drug of choice.

“Amoxicillin is our number one prescription that we basically use in children,” she said. “A shortage of amoxicillin is very concerning for pediatrics.”

At NUMC, she has not encountered this problem yet, and the hospital doesn’t foresee that it will, but if the numbers of RSV keep rising, that could change.

“I can definitely see it becoming a problem if we have a sudden, even worse uptick in RSV after Thanksgiving or holiday break,” she said. “Then it could become a big problem.”

Dr. Ejaz thinks the shortage is due to the medical community focusing on other medications the past few years due to the Covid-19 pandemic.

“I think in the last two years, everybody was focusing more on Covid, and kids were not going to school so they were not getting as sick,” she said. “So there was less demand of amoxicillin and all of a sudden now people are realizing that, okay, we kind of overlooked this part of kids going back to school.”

Dr. Jessica Berrios, the acting chair of emergency medicine at NUMC said that because pediatrics uses amoxicillin way more than adults, she doesn’t think there will be an issue.

“There’s a lot of talk about potentially thinking about other types of medications just in case there is a complete unavailability of it,” Dr. Berrios said. “It’s easier for us because we can use different medicine to treat the same sort of complaints which would be like pneumonia, and bronchitis.

“But I feel like when the season comes of these viral infections, we tend to see less bacterial infections,” she explained. “But we have been seeing Covid which is sticking around.”

Dr. Berrios explained that because of masking during the pandemic, doctors weren’t seeing many viruses affecting patients, but now that people are starting to wear masks less often now, they’re back.

“We’re going out more, so the cold viruses will spread,” she said. “And I think even with Covid, it will just be a cold virus, a regular coronavirus like it was before.

“But I think that these viruses are just going to have to take their course and then we’re going to have to just get through them and then hopefully they will also just sort of peak off.”

The best way to stay healthy, both Dr. Ejaz, and Dr. Berrios agreed, is to get vaccinated.

“Although we don’t have a vaccine for RSV, I strongly recommend all the parents to take their flu shot, and give it to the kids that are old enough,” Dr. Ejaz said. “Same thing with the Covid vaccine.”

It is safe to get the Covid booster and the flu shot at the same time, Dr. Berrios said, and she suggests everyone become up to date with their Covid and flu vaccines.