Covid-related precautions helped minimize the spread plenty of other communicable diseases. But now, those bugs are back, along with some new challenges. The CDC reports that strep A infections (a.k.a strep throat), caused by a bacterium known as A Streptococcus, have surged from covid lows to above pre-pandemic levels in 2022 and 2023. And the recent spike in strep cases coincides with a shortage of one of the medicines most commonly used to treat the infections, particularly in children, as pointed out in a Monday NPR report.

Nationwide, the biggest sustained increase in the number of the most severe strep cases (known as invasive group A strep infections) has been observed in children, according to the CDC. And kids are the group most affected by ongoing antibiotic scarcity.

Currently, many dosages of liquid amoxicillin, the goopy bright pink drug of choice for pediatric strep infections, are in short supply, according to the Food and Drug Administration. And it’s been this way for months. Many forms and brands of the powders used in liquid amoxicillin formulas have been under an official FDA shortage since October 2022. Most of the pharma companies that manufacture the stuff have listed “demand increase for the drug,” as the reason behind its limited availability.

Though higher than the past normal, strep infection levels haven’t appeared to reach any sort of record levels in recent months. However, as NPR notes, companies often rely on recent sales data to inform their production. In using pandemic years as data points, these pharmaceutical manufacturers many have miscalculated.

“Companies typically look to see what their sales were the prior year. They might make a little bit of an adjustment,” Erin Fox, a medication use and policy researcher at the University of Utah, told NPR. “With the really severe respiratory season we’ve had this year, it just simply was a mismatch between what people manufactured and what was available,” she added.

There are alternative options for treating strep infections. Doctors can prescribe other dosages or pills over certain liquid forms of amoxicillin. However, getting kids to swallow pills or larger volumes of liquid medicine can be a challenge.

Doctors may prescribe a medicine unaware it’s in short-supply, putting the onus on the patient or patient’s family to navigate the pharmacy system and find what they were told they need. Caitlin Rivers, a Johns Hopkins University epidemiologist, told NPR she had to go to multiple pharmacies in order to find a prescribed antibiotic for her own child. “It just adds another burden on what’s already been a really difficult winter respiratory season for families,” she said to the outlet.

But despite the inconvenience, getting proper medication for strep is critically important. Untreated, strep A infections can lead to serious, long-term consequences like organ damage or rheumatic fever.

The worst time of year for strep infections is often December through April, so the spike in cases and concurrent struggle to find meds could settle down soon. But years of pandemic threw many seasonal infection cycles out of whack, and there’s no guarantee that next month will bring relief, Rivers said.

Over the past year, the FDA has declared shortages on many commonly prescribed medications, including other antibiotics. Other shortages include certain types of ADHD medications like immediate release Adderall and multiple brands of a newer class of diabetes drugs that are also often used for weight loss. Supply chain disruptions, increases in demand, and a mix of other factors are to blame.

Regardless of the causes, drug shortages can have significant negative impacts on medical care, quality of life, and health. Out of desperation, some people have sought out unsafe sources of medication, like pharmacies outside of the U.S., which may not be selling things exactly as labeled.


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