Drugstores struggle to stock antibiotics, children's medicines

Hundreds of U.S. community pharmacies, including some in Metro Detroit, are having trouble stocking antibiotics, common over-the-counter therapies for children and a widely used drug for ADHD as shortages persist.

About 4 out of 5 pharmacies reported problems filling prescriptions for the antibiotic amoxicillin in a National Community Pharmacists Association survey completed by 332 stores at the end of January. Some 93% were short of children's pain and fever medicines, according to the survey, and 97% lacked access to adequate supplies of branded or generic Adderall, the treatment for attention-deficit/hyperactivity disorder.

All the drugs have been in short supply in the United States or Canada for months for different reasons. Supplies of children's amoxicillin, as well as kids' over-the-counter pain and fever medicines, ran low in October as viral illnesses that can lead to bacterial infections spiked earlier than usual. Adderall has been hard to find since August as Teva Pharmaceutical Industries Ltd., the main manufacturer for the United States, lacked workers to produce sufficient supply while demand was soaring.

The Food and Drug Administration is reporting shortages of Adderall and liquid amoxicillin and increased demand for children's fever drugs. Nearly all European Union states have reported amoxicillin shortages.

Several Metro Detroit pharmacies said they were impacted by the national shortages in Adderall, amoxicillin and children's pain medications like Tylenol and Motrin. Sam Baadani, head pharmacist at ProCare Pharmacy Highland Park, said his main suppliers have been intermittently out of or running low on these medications for the past six months. 

"We've been completely out of Adderall recently, we've been completely out of Tylenol at times and amoxicillin," Baadani said. "The suppliers are out; we try to utilize secondary suppliers as well whenever we can to find the medications that are short. But whenever we have no luck, we have to just check back every morning for stock and try to order as much as we can when we can get it."

The shortages of antibiotics and fever medications for children have been particularly worrisome, Baadani said.

"When you have patients, especially in the wintertime, that are coming down with certain respiratory viruses and the flu and COVID and RSV, fever control is very important," Baadani said. "With the amoxicillin, if there's a particular concentration available and the concentration that was prescribed is not available, we'll reach out to prescribers and adjust the dosage or adjust the amount given to match the specific dose ... to be able to accommodate a patient."

When Baadani's pharmacy cannot fill a prescription, employees sometimes have to reach out to others nearby and transfer it. 

Two major manufacturers anticipate that amoxicillin supply will continue to be limited for months. Leslie Pott, a spokesperson for Novartis AG's Sandoz unit, said the situation is improving but that constraints will continue at least into April. Valerio di Caprio, a global vice president at Netherlands-based Centrient Pharmaceuticals, one of the leading makers of amoxicillin's active ingredient, said the shortages will continue for the next few months.

Stocks of over-the-counter kids' medicines are increasing, according to the Consumer Healthcare Products Association, a U.S. trade group for makers of over-the-counter drugs, but "intermittent out of stocks may still persist in a few areas." Meanwhile, cases of flu and respiratory syncytial virus or RSV, another common lung infection, continue to abate nationwide, according to the Centers for Disease Control and Prevention.

It's a particularly severe time for drug shortages in the United States, according to the University of Utah's drug information service, which tracks drug supplies. During the last quarter of 2022, there were shortages of 295 medicines, the most in a quarter since at least 2018.

Bloomberg Staff Writer Ike Swetlitz and Detroit News Staff Writer Hannah Mackay contributed.