December 9, 2022

Doctor calls on Ontario to get more antibiotics for children

A Toronto infectious disease specialist says the government must immediately get more antibiotics used to treat children because ‘little is being done’ to address Ontario’s drug shortages amid a poor virus season.

“We are seeing an increase in respiratory viruses like influenza, RSV (respiratory syncytial virus) and of course COVID-19, among other respiratory viruses that are circulating. This is against the backdrop of flooded pediatric emergency departments and the strain on the healthcare system,” Dr. Isaac Bogoch told CP24 on Tuesday morning.

Health Canada announced on Monday that four pharmaceutical companies – Sanis Health, Apotex, GSK and Teva Canada – are experiencing shortages of medicines containing the antibiotic amoxicillin.

The drug is commonly used to treat a range of illnesses in children, including chest and ear infections. The antibiotic comes in powder form for children that pharmacists mix with a liquid, and in pill or capsule form for adults.

Health Canada said it would follow up with companies and “take action” alongside drugmakers, provinces and territories to resolve supply issues.

The national health agency added that there are eight other drug makers offering amoxicillin-containing drugs that are not currently reporting supply issues.

The drug shortage comes amid a shortage of Tylenol and Advil supplies for children in Ontario, which began in August due to increased demand and supply chain constraints.

Ontario Pharmacists Association CEO Justin Bates said increased demand for antibiotics during the current viral respiratory season is also behind the amoxicillin shortage.

“…Unprecedented demand, over 300% above normal seasonal consumption patterns, has led to what we call a demand-driven shortage and now it is hitting children’s amoxicillin liquid formulation and we will having to look for ways to mitigate this and provide rations, as well as provide alternatives for parents,” he told CP24 on Monday.

Bates said it could take months to replenish the stockpile of amoxicillin, which is now urgently needed to combat rising colds and flu.

“Because this is a prescription product and not over the counter…we expect it (the shortage) to be much more severe in terms of duration, and could even be from January to March” , did he declare.

The Ontario Ministry of Health said shortages are expected to last until the end of the year for many products, but other drugs can be used as an alternative to amoxicillin.

“The estimated end of shortage dates for several products are currently showing as November or December. A number of other antibiotics, funded by the Ontario Drug Benefit (ODB), can be used to treat patients in place of amoxicillin. patients to speak to their pharmacist or prescriber if they cannot obtain amoxicillin products,” a Health Department spokesperson wrote in a statement to on Tuesday.

Canada is not the only country experiencing a shortage. The United States Food and Drug Administration also reports a shortage of amoxicillin due to increased demand for the drug.

As Ontario faces drug shortages, many pediatric hospitals across the province are reporting high numbers of emergency room visits due to an early rise in childhood illnesses.

Ontario’s Chief Medical Officer of Health Dr. Kieran Moore said the health care system will see a “triple threat” of COVID-19, a bad flu season and the resurgence of a childhood respiratory virus this fall and this winter.

Bogoch told CP24 on Tuesday that it appears little is being done to address drug shortages since they began this summer.

“I mean, it’s a big problem and of course the problem with fever medications lasts for months. We saw this problem in the summer as well. I won’t claim to be a supply chain expert, but it is clear that we have known this for some time and it seems that very little is being done to curb this problem, ”he said.

Bogoch acknowledged there was ‘no quick fix’ to get more supplies, but said if the government wanted to ease the strain on the healthcare system, it needed to give parents the tools to s take care of their children at home.

“So whether it’s the federal government, the provincial government, whatever regulator or agency is responsible for providing citizens and the public with medications, including fever medications and antibiotics, I want say, let’s go because we still have a long fall and winter ahead and this problem is not going away,” he said.

CP24 has contacted the Ontario Ministry of Health for comment.

Until the supply is replenished, Bruce County pharmacist Kristen Watt told CP24 that some adult drugs could be used to treat children, but that’s on a case-by-case basis.

“So for pain and fever, we’re looking at using the adult strength of ibuprofen or acetaminophen and dosing those for children,” she said.

“But when it comes to antibiotics, it’s a whole different ball of wax. We are going to have to work with the prescribers, we have to understand why we are treating children. There are adult pills and capsules that we could use or we may have to research alternative antibiotics, walk the line and select other alternatives,” Watt added.

Watt said pharmacists in Ontario aren’t able to select alternative medications for their patients, but if they could, it would help keep patients out of hospital.

“If we had the patient in front of us knowing their diagnosis, if we could just select an alternative, but there’s a limit in our ability to practice right now,” Watt said.

To reduce the number of COVID-19 patients in hospital this winter, Ontario is considering allowing pharmacists to prescribe the COVID-19 treatment drug Paxlovid to patients.

Bogoch said it was a “perfect strategy” to ease pressure on the healthcare system this winter.

“Who better to do that than a pharmacist in a pharmacy. If we can take other complications and other people out of the equation and simplify it so that someone can have symptoms, go to a pharmacy, get tested, test positive, and start this Paxlovid safely safely and quickly, we are clearly doing something right. It’s a smart move,” he said.

With files from The Canadian Press