December 9, 2022

Shortage of antibiotics for children in Quebec

The most commonly prescribed antibiotics for children in Quebec are in short supply right now, likely due to increased demand after more children than usual fell ill this fall.

“We have problems with Clavulin,” among other antibiotics, said Pierre-Marc Gervais of the Association of Proprietary Pharmacists of Quebec (APQ). The main active ingredient in Clavulin is a penicillin called amoxicillin.

Amoxicillin is by far the most frequently prescribed drug in the pediatric age group, as it covers the most common bacterial infections in children, such as pneumonia and ear infections, according to infectious disease specialist Dr Earl Rubin at the Montreal Children’s Hospital.

“It’s really first-line therapy,” said Rubin, who added that they only heard about the “amoxicillin problem” yesterday.

The QPOA discovered the supply problem about a month and a half ago after reviewing the data they collect on the types of prescriptions filled and noticing an increase in the number of pediatric antibiotics being prescribed.

When they asked why the shortage was happening, manufacturers told them they had increased production, Gervais said.

“We have seen a disruption in the supply chain…and many active ingredients are made in other countries, mainly in Asia, so sometimes it takes a little longer to get the product into Canada,” said he explained.

Gervais and Rubin agree, however, that the main reason behind the shortages is the “unprecedented surge” in respiratory viruses affecting children in the province.

This is compounded by the over and inappropriate prescribing of antibiotics as well as the shortage of some Tylenol products used by children for fever and pain relief, Rubin said.

“You put all of these things together and it’s a perfect storm,” he said, noting that no matter how much parents want to end their child’s suffering, “antibiotics do nothing for children. virus”.

“We hear over and over again of parents saying, ‘I went to the doctor and they say it’s viral and there’s nothing you can do.’ Parents are frustrated by this response, but in fact it is,” he said.

This medical certainty can also frustrate a doctor when faced with a squirming, miserable toddler and parents seeking treatment.

That’s when they can prescribe antibiotics anyway, not only to offer some sort of remedy for the family, but also because outside of a hospital setting, a doctor usually doesn’t have access to a test that diagnoses a viral illness.

“So it’s often difficult to differentiate a virus from something else that’s causing the fever,” Rubin said.

Historically, overprescribing was for suspected ear infections, Rubin said, which is a common complication of a virus, but he said more than two-thirds of children over the age of two improve with time alone.

“But you have to give Tylenol and Advil to get them through that,” he said, and there have also been shortages of acetaminophen liquid suspensions used for children in Quebec.

It’s unclear when the supply will be fully replenished, but Gervais said that in the meantime, when a pharmacy doesn’t have access to a certain antibiotic, they will find a substitute.

“We are always trying to find solutions,” he said.

With files from CTV Montreal’s Tania Krywiak.