The government has added antibiotics used to treat strep A infections to the list of medicines that cannot be exported from the UK or stockpiled as GPs continue to struggle with supply shortages.
As of today, amoxicillin and penicillin V are on the list issued by the Department of Health and Human Care (DHSC)along with azithromycin and cephalexin.
It follows a DHSC drug supply notification on December 12 that supplies of antibiotics for the treatment of group A strep have experienced increased demand “and may be temporarily in limited supply at certain wholesalers and pharmacies.”
Manufacturers have supplies and deliveries to wholesalers and pharmacies will be expedited in the coming days, according to the notification.
NHS England has published guidance on strep A for clinicians, in collaboration with the RCGP and other organizations, which advises having a low threshold for antibiotic prescription and hospital referral in primary care.
It also advises which treatment to use if first-line antibiotics are not available and how to use solid dosage forms in children by crushing or dispersing tablets in water if necessary.
Pharmacy wholesalers have confirmed that the availability of antibiotics should improve and more stock was delivered every day.
Pulse had reported last week that a spreadsheet was distributed to GPs demonstrating that the three major national pharmacy wholesalers, Phoenix, Alliance, and AAH, are currently out of stock of Amoxicillin Suspension 250 mg/5 mL or Penicillin V Suspension 125 mg/5 mL or 250 mg/5 mL.
There have been 15 confirmed deaths of children from strep A since September.
GP visits for scarlet fever and disease notifications are rising more than expected for this time of year, as are cases of invasive group A strep, albeit less pronounced. The UK Health Insurance Agency (UKHSA) has warned.
A total of 6,285 cases of scarlet fever have been reported in England and Wales in the last six weeks, with more than 13,000 cases between weeks 27 and 49, the The latest figures from the UK Health Insurance Agency show.
Dr Richard Cook, a GP in West Sussex, said the last two days had been the busiest he had seen in his practice.
“We have been inundated with children for the last 48 hours. The availability of antibiotics is very scarce, which is not helping.’
Professor Azeem Majeed, a GP and professor of primary care and public health at Imperial College London, said: “We are getting reports from all over the country about shortages of antibiotics, particularly children’s formulas.”
‘My own practice was informed by our local pharmacist last week that they had run out of their last few bottles of amoxicillin.
“In these circumstances, I think it makes sense to try to improve the availability of key antibiotics in the UK.”
Meanwhile, the Competition and Markets Authority confirmed it will investigate after reports from pharmacists that antibiotic prices have risen amid increased demand.
A CMA spokesman said: “People have real concerns about the price of antibiotics used to treat strep A, and we want companies to be clear about their obligations under the law.” There should be no question that it is illegal for a dominant company to charge excessive prices, or for any company to collude to drive up prices.
‘We are working to establish the facts of what is currently happening in the market and receive new information as part of our work. We stand ready to take action if there is evidence of anti-competitive behavior that violates the law.’