Does amoxicillin deficiency endanger the health of our children?

In recent weeks, pharmacists have struggled to fill their cabinets. Amid surging demand and disrupted deliveries, some antibiotics are now missing. To the point of pushing the health authorities to act. The public medicine agency (Ansm) has thus evoked the “strong supply tensions” of amoxicillin, an antibiotic widely used to treat children.

The shortage could last into March, leaving parents fearing a difficult winter. But why is this drug out of stock? How will we be able to take care of the children? 20 minutes takes stock with Pierre-Olivier Variot, president of the Union of Community Pharmacists.

What is Amoxicillin?

Its name may not tell you anything, yet it is the most widespread antibiotic. “It is a historical antibiotic, derived from penicillin, which is used as a first-line treatment to treat many things,” explains Pierre-Olivier Variot. It is given in particular against “ear infections, toothaches” or certain pneumonias. “In combination with clavulanic acid, it is also used more specifically for more resistant infections,” explains the pharmacist. But amoxicillin is mainly given to children alone, “especially in syrup”, against most bacterial infections.

Why is there a risk of a shortage of this drug?

It is precisely on the syrup that French pharmacies are “already eager to supply”, underlines the pharmacist. Several causes combine. “First, there is tension on the production of the molecule because demand is exploding” globally, explains Pierre-Olivier Variot. After several years marred by Covid, the spread of other diseases had slowed, and supplies weren’t always following. Then, the sector is indirectly affected by the war in Ukraine and by the soaring prices of energy and some raw materials. “Even the glass bottle used for the syrup is under strong tension”, specifies the president of the Union of Pharmacy Unions, as is aluminum, making “the sachets more difficult to produce”.

But that is not all. “The supply tension is global, but it’s most marked in France,” according to him. In question, the price of the drug. “The production line is complex to set up because everything has to be clean, we don’t want to end up with another molecule in the bottle,” he explains. However, after years of intense vaccine production for example, “transforming a production line to sell amoxicillin in France is not profitable”. “We pay to have the cheapest medicines in Europe: in France a pack of amoxicillin is sold for two or three euros, against twelve or thirteen in Great Britain, for the same production cost”, observes Pierre-Olivier Variot.

Will we be able to take care of our children this winter?

As in any deficiency, “we must rationalize the use of this antibiotic”, believes Pierre-Olivier Variot, while “we do a lot and not always wisely”. The pharmacist thus relies on doctors to “educate the population”: “if we only do the Covid test and give an antibiotic“ just in case ”, the patient runs no risks and chooses the drug,” he urges. In the absence of amoxicillin, “we can transfer the patient to other antibiotics that are less used, but which will therefore also be in tension”, he warns.

It is therefore essential to make more precise diagnoses. “There are tests that make it possible to check three viruses: Covid, influenza and RSV”, at the origin of bronchiolitis, of which France is experiencing an epidemic. Another type of test, “in the Netherlands there is a CRP test, the level of which varies according to whether the infection is viral or bacterial, and this for all types of infections”, Pierre-Olivier Variot enthuses. When the test shows the presence of a virus, the drug is useless. “If we could get these tests covered by health insurance, we would reduce antibiotic use” without affecting the care provided, he says. In the Netherlands, the use of amoxicillin has thus decreased by 45% with the new tests. This would allow French pharmacies to have enough supplies throughout the winter for children who will need them.

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