Stark County pharmacies coping with antibiotic shortages as demand rises

CANTON − A nationwide shortage of antibiotics, particularly liquid amoxicillin typically prescribed to children, hasn't hindered local pharmacists.

Zack Fettman, a pharmacist at Davies Drugs, said they are able to compound amoxicillin ― turning adult capsules into a liquid children's dose that's easier to swallow. The medicine is used to treat secondary bacterial infections caused by the respiratory syncytial virus (RSV) and strep throat.

"With the amoxicillin, because it's on shortage in the FDA's eyes, they've given the go-ahead to go ahead and start compounding it from the capsules to make sure that the liquid stays available," Fettman said.

Why the antibiotics shortage?

Fettman said there might be multiple factors contributing to the shortage, such as staffing at manufacturing plants and FDA drug scrutiny that's resumed since the urgency of the pandemic largely has passed.

Most media reports cite drugmakers that attribute it to high demand amid an early respiratory illness season.

The FDA first listed a shortage of the powder used to formulate liquid amoxicillin on Oct. 28. Three of the drug manufacturers that reported a shortage listed "demand increase for drug" and one listed "other" as the reason.

Erin Domenico, executive director of Aultman's pharmacy, said the health system began to prepare for antibiotic shortages this summer when there were early predictions for a "tridemic" ― an uptick of COVID-19, flu and RSV cases.

"Drug shortages are definitely nothing new," she said. "There are drugs that we see that have been on shortage for the last three years, and it's something that we have to work through every day in our workflow."

Jason Briscoe, director of pharmacy operations at Discount Drug Mart's 77 stores in Ohio, said there's been an increased demand for antibiotics, specifically liquid antibiotics containing amoxicillin, for at least the last three months.

"The demand for these medications really has led to a shortage of them," he said. "To my knowledge, there hasn't been any issues with raw materials or there hasn't been any issues with a manufacturer's plant shutting down. It's just purely the demand has outpaced the supply."

Since the demand is known now, Briscoe said, he expects production to catch up soon. He added that most the medications currently in short supply have a "pretty long shelf life."

Pharmacies, hospitals well-prepared

Domenico said Aultman keeps up to date on public health outlooks and news about drug manufacturers to help predict drug shortages. Ordering medicine directly from manufacturers, instead of a wholesaler, is one way the health system ensures it will have what patients need.

The Aultman pharmacy serves affiliated physicians, urgent cares and emergency departments. Domenico said antibiotics given to patients in hospitals tend to be stronger than amoxicillin, which is more often given to people who can be treated without being admitted to a hospital.

The drug shortage Aultman has experienced more is Tamiflu, an antiviral drug that treats the flu. Expecting about the same number of flu patients as the previous year, when flu rates were lower amid more pandemic precautions, "wasn't a very good prediction," Domenico said.

"However, we've been able to, like I said, we start with our manufacturers and trying to secure allocations," she said. "We've been very successful in doing that for Tamiflu and making sure that we have it for our patients.

Discount Drug Mart also receives medications direct from manufacturers and has its own pharmacy warehouse, which has helped during the supply "ebbs and flows," Briscoe said. The stores have filled competitors' prescriptions and would transfer prescriptions to other pharmacies if they didn't have the drug.

On a few rare occasions, Discount Drug has compounded medicine, which only can be done if it's not commercially available. Briscoe also reported a shortage of generic Tamiflu.

"Yes, there have been shortages," he said. "We haven't been terribly impacted. But when we have to, we'll do what we have to do to help that young person get treated."

Fettman at Davies Drugs said much the same.

"Pharmacies have been adapting to make sure that the needs of the community are met," he said. "I think that that's really the drive-home message at this time with the shortages."

Reach Kelly at 330-580-8323 or kelly.byer@cantonrep.comOn Twitter: @kbyerREP

This article originally appeared on The Repository: Antibiotics in demand: Local pharmacies meeting needs amid shortages