Antibiotic supply gone from bad to worse, say pharmacists

Pharmacists say supplies of key antibiotics to treat strep A have "gone from bad to worse" in the past week.

The Association of Independent Multiple Pharmacies (AIMP) said the situation was "unacceptable" and it was time for the government to get a plan in place.

Four antibiotics, which treat different conditions, have been added to a list of products that the UK cannot export.

The UK government says it is working urgently with manufacturers and wholesalers to speed up deliveries.

However, Leyla Hannbeck, chief executive of the AIMP, which represents 4,000 pharmacies in the UK, said the supply of antibiotics to treat bacterial infections including strep A and scarlet fever was "very poor".

She said the problem had been highlighted a week ago, but it was now getting worse, making it very difficult to get hold of any antibiotics.

"People are having to go from one pharmacy to another - it's chaos," she said.

"Supplies are not coming through to us and it feels like no-one cares."

Dr Hannbeck said putting four antibiotics - three of which are go-to treatments for strep A - on the banned UK export list because of high demand was "too little too late".

Amoxicillin, phenoxymethylpenicillin (penicillin V), azithromycin oral suspension and cefalexin are used to treat a large range of bacterial infections, including throat, chest and skin infections.

Her message to worried parents is that pharmacists are working very hard to find alternatives, and also changing formulations from solid pills to liquid medicines.

But even the alternatives are running short, Dr Hannbeck says.

A spokesperson from the Department of Health and Social Care said manufacturers currently have supplies of antibiotics to treat strep A and they are trying to get that stock to pharmacies.

"We continue to work urgently with manufacturers and wholesalers to expedite 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, and support access to these vital medicines," they said.

GPs have been advised to prescribe antibiotics for children who may have worsening symptoms linked to strep A, a bacterial infection which can lead to scarlet fever and, very rarely, a serious and fatal invasive infection called iGAS.

Strep A infections tend to increase in the winter and peak in the spring, but this year cases are rising at an earlier point than usual - probably because of changes in the normal cycle of infections due to the pandemic.

Since September, 15 children in the UK have died after severe iGAS infections, according to the UK Health Security Agency. Figures for England show that 45 adults have also died from the same condition in the same period.

This is the highest number of deaths since the winter of 2017-18, when 27 children and 328 adults died with invasive strep A.

The trade body which represents drug wholesalers, the Healthcare Distribution Association (HDA), said more stock of antibiotics was being delivered into warehouses now and would be with pharmacies in the coming days.

Martin Sawer, executive director of the HDA, said one national wholesaler had told him that demand for medicines had risen by 400-500% on last December.

"We are prioritising all the antibiotics amid huge demand for them, particularly liquid solutions," he said.

Pharmacists also say they are being charged up to £19 for a pack of drugs that normally costs a few pounds, after prices went up sharply amid a rise in cases of strep A.

As a result, they say they are losing thousands of pounds a week because only a fraction of what the drugs cost can be recouped from the NHS.

The Competition and Markets Authority is now investigating the pricing of antibiotics by drug companies. It says it wants companies to be clear about their legal obligations.

"There should be no doubt that it is illegal for a dominant company to charge excessive prices, or for any companies to collude to drive up prices," the CMA said.

Additional reporting by George Bowden.