- Tylenol, Amoxicillin, Tamiflu and Albuterol are all proving hard to find for some parents.
- Experts recommend asking your pharmacist if alternatives are available, such as generics or capsules.
- Do not give adult medications to children.
Pharmacists across the country are struggling to keep four common medications on their shelves as a big wave of winter illnesses deplete their stocks of children’s medicines.
The four drugs, which can help reduce fever, fight bacteria and viruses, and help patients breathe, are in short supply for several different reasons.
- Amoxicillin (an antibiotic that treats bacterial infections)
- Tamiflu (an antiviral that fights the flu)
- Albuterol (a bronchodilator that helps treat and prevent breathing difficulties)
- Children’s Tylenol (a pain reliever and fever reducer)
There are alternatives to amoxicillin, for those who really need it
CDC Director Rochelle Walensky says she’s urging doctors to properly prescribe antibiotics this fall. The U.S. Food and Drug Administration says liquid amoxicillin for children will be in short supply until the spring of 2023 due to “increased demand.” But this request is not always appropriate. Studies suggest that around 30% of antibiotics are prescribed incorrectly – often for viruses that cannot be treated with antibiotics, such as influenza, COVID and RSV.
There are children who could really benefit from antibiotics, however. Strep throat, for example, which is one of the most common bacterial infections in the world, is back in rotation this fall after a few years of low circulation during the pandemic.
Dr. Anthony Flores, chief of pediatric infectious diseases at Memorial Hermann Hospital and UTHealth Houston, told Insider that providers can perform rapid strep tests to confirm a patient’s diagnosis. They should also look for the telltale sign that a patient is dealing with bacteria and not a virus: large, red, pus-covered tonsils.
In this case, doctors like to prescribe amoxicillin because “it tastes good,” Flores said. “Kids take it very easily.”
Although liquid amoxicillin can be hard to find, the American Society of Health-System Pharmacists, which monitors drug shortages, says there is still a limited supply of some chewable and tablet versions of amoxicillin.
Doctors can prescribe capsules even for children who aren’t yet swallowing pills, Dr. Sallie Permar, chief pediatrician at NewYork-Presbyterian Komansky Children’s Hospital, told Insider. In this case, caregivers can open the capsules and give children the powder inside, Permar said.
There are other alternatives. One of Flores’ favorite amoxicillin substitutes is called Keflex (generic name: Cephalexin), but there are many other antibiotics to choose from when treating a case of strep throat. Doctors will consider various factors like the patient’s allergies, so these prescriptions “will depend on the clinical scenario” at hand, he said.
For albuterol, Tylenol and Tamiflu, experts recommend alternatives including generics and compounded preparations
Dr Permar said many of the “standard” drugs used to treat pediatric respiratory disease are “increasingly difficult to find in stock” during this year’s first wave of respiratory disease, which arrived before the manufacturers are prepared to meet a surge in demand.
If you’re having trouble finding children’s Tylenol, try a generic version of the drug (called acetaminophen) that works just as well, Permar said. Just make sure it is always a children’s formulation – the adult dose of the drug will be too high for children and may be toxic to their liver.
Trained pharmacists may be able to compound adult medications into child-friendly formulations in the event of a shortage, suggested pharmacist Rima Arora, director of pharmacy at online pharmacy DiRx.
But “never try to do it yourself,” pediatrician Joanna Dolgoff, spokeswoman for the American Academy of Pediatricians, told The Washington Post.
Neither the FDA nor the ASHP report any shortages of acetaminophen, which means generic versions of Tylenol should be relatively easy to find.
If your typical albuterol prescription is hard to find, the American College of Allergy, Asthma and Immunology suggests asking your supplier for an alternative. Or, you can even use an outdated inhaler you might have at home, “because it’s probably still at least partially effective” – that’s what the ACAAI has suggested in previous guidelines, issued when albuterol was widely used for respiratory problems related to COVID-19 in early 2020.
According to the FDA and ASHP, the albuterol shortage may last until spring 2023.
If you cannot receive Tamiflu for your children, Arora said, don’t panic. “Viral infections in otherwise healthy patients can still be treated with rest and fluids,” she said. The shortage of Tamiflu is expected to ease fairly quickly, by the end of December. In fact, the FDA does not even list oseltamivir (the generic name for Tamiflu) in current shortages.
Finally, you can also shop in different pharmacies, as some may have in stock what others do not. Permar acknowledges that it can be a “time-consuming” chore for busy parents, “therefore knowing about alternative recommendations can be helpful,” she said, such as looking for generics or using powder. instead of liquid.
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