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Strep A: Children can take oral solid form antibiotics amid demand surge

Whole doses of solid oral antibiotic forms can be used in place of oral suspensions in children with group A strep, according to new guidance.

It follows concerns about mounting cases of strep A infections in children, with pharmacists flagging difficulties in getting hold of amoxicillin and penicillin in particular.

Children, including those with group A strep, can now be given whole doses of solid oral forms of some antibiotics “off label” instead of oral suspensions, according to guidance from the Specialist Pharmacy Service released yesterday (December 7). 

Read more: Strep A: No antibiotics shortage, just ‘huge’ surge in demand, say wholesalers

The eight antibiotics that can be used in this way include erythromycin, phenoxymethylpenicillin, and azithromycin.

Although children should be encouraged to swallow oral dose forms where possible, the guidance includes advice on how doses can be taken by dispersing or crushing tablets or opening capsules.

Taking the medicines in this way is “off label”, the guidance noted.

The guidance also provides advice on how to mask the “bitter” taste of certain antibiotics, including using a strongly flavoured drink or food that the child likes.


Pharmacists flag supply issues


It comes as pharmacists raise concerns about the availability of antibiotics, despite health secretary Steve Barclay insisting there was a “good supply” of penicillin yesterday.

The Department of Health and Social Care (DH) told C+D earlier this week (December 5) that it did not know of any supply issues affecting amoxicillin.

Read more: Strep A: Pharmacists warn of amoxicillin shortages as infections rocket

But the Association of Independent Multiple pharmacies' CEO Leyla Hannbeck told Times Radio yesterday (December 7) that pharmacists all over the UK are finding that antibiotics are out of stock whenever they try to order them from wholesalers.

"I don't know where [DH officials] get their facts from," she told listeners. Pharmacists on the front line "simply cannot get the products".

She was unconvinced of the DH's statement that there is sufficient stock of antibiotics to treat group A strep.

She said: "If they've got plenty of it, let's see it. Where is it?"

Meanwhile, Healthcare Distribution Association executive director Martin Sawer told C+D on Tuesday evening (December 6) that “there is not a shortage” of antibiotics commonly used to treat invasive group A strep.

“But [the] product is not yet in the supply chain in sufficient quantities to meet the current sudden huge demand surge,” he explained.

“Wholesale distributors are working hard with their manufacturer partners to increase supply to meet this unprecedented demand,” Mr Sawer said.

At least nine children in the UK have died from strep A infections this year.

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