Pharmacists warn antibiotic stocks for respiratory illnesses at 25-year low

IPU president Dermot Twomey said his Cork pharmacy is down to the last two bottles of one type of children’s antibiotic. Picture: Eddie O'Hare

GPs are inundated with demands for antibiotics at a time when pharmacists have warned supplies of some products for respiratory illnesses are at a 25-year low.

According to the Irish Pharmacy Union (IPU) president, there is a lack of some essential medicines. Dermot Twomey said his own business was down to the last two bottles of one type of children’s antibiotic.

The medicines regulator has listed four products containing penicillin, which is used to treat Strep A, as out of stock, and Mr Twomey said other listed shortages for respiratory sicknesses are more concerning.

Numbers of RSV cases are climbing again, reaching 678 last week following a dip the week before which had led to hopes the wave had peaked. This is not treatable with antibiotics.

Mr Twomey, a pharmacist in Cloyne, Co Cork, said of the shortages: “It’s very serious, particularly for the kids. This is the worst I’ve seen it in 25 years that I’ve been working as a pharmacist."

Pharmacists substitute other brands but this is not ideal, he said, adding that common antibiotics are proving difficult to obtain.

“Amoxicillin 125 has gone short now. We managed to get two more bottles and that is it,” he said.

Irish and English health authorities are discussing the blanket use of antibiotics containing penicillin in areas affected by Strep A following the death of one child in Ireland and 13 in England.

However, chief clinical officer Dr Colm Henry cautioned this is a “double-edged sword” and would be assessed in each region.

A spokesperson said: “The HSE is currently assessing the demand for and supply of antibiotics to ensure we have sufficient for the needs of our primary care and hospital teams."

European countries are also facing shortages, with reports indicating French pharmacists were asked to ration paracetamol packages. Shortages have worsened due to Covid-19 and the war in Ukraine, the Pharmaceutical Group of the European Union said.

Tánaiste Leo Varadkar said the Government had not been informed of any shortage of oral or IV penicillin, but said that they were “aware of what’s been signalled in the UK” and would be following up with health officials.

He also said that while the Government is "very concerned" about Strep A, there are no plans to segregate children into pods or anything similar to the measures taken during the Covid pandemic.

Irish Medical Organisation GP chair Dr Denis McCauley said: “The important thing is that parents have a tool-kit to recognise when a child is very sick and seek a medical opinion quickly, but in the vast majority of cases the child will have a sore throat, a cough, a mild temperature. In those cases, you wait two days, and only then you go and see the doctor.” 

Penicillin shortages

Referring to penicillin shortages, he said: “I’m not surprised. That cohort that I would want to wait two days are not waiting, they are piling in and everybody is getting an antibiotic.” 

Mr Twomey called for an EU-level discussion on procurement following shortages including of diabetes and HRT products. He suggested a Serious Shortage Protocol (SSP) be established, which would more easily allow medication substitutions.

It is understood Health Minister Stephen Donnelly has previously asked health officials to examine the possibility of an SSP after prior requests by the IPU and he is waiting for their response.