Strep A deaths: Drugs bosses warn of antibiotics shortage in Scotland

Pharmaceutical bosses have insisted Scotland, along with the rest of the UK, is experiencing a shortage of antibiotics to fight the growing threat of strep A infections, despite the assurances of both Holyrood and Westminster.

Infections caused by group A streptococcus (GAS) have been increasing in Scotland in the past two months, according to Public Health Scotland (PHS).

Whilst GAS infections, which commonly present as scarlet fever, are common, the more serious invasive group A streptococcal (IGAS) infections are rare, and have been responsible for the deaths of 15 children in the UK since September. There have been no deaths confirmed in Scotland.

Now pharmaceutical officials are warning Scotland and the rest of the UK is experiencing a shortage of the antibiotics used to treat IGAS in children.

Illnesses caused by Strep A include the skin infection impetigo, scarlet fever and strep throat

Abbas Kanani, an NHS consultant, superintendent pharmacist, and Member of the Royal Pharmaceutical Society, said: "There are supply issues across the UK, including Scotland. There has been an increase in demand over the last few months, namely the last few weeks, which is why specific guidance has been issued, advising on how to administer oral formulations to children.

"If there was no shortage, this guidance would not be issued. Antibiotic suspension for children is limited at this current time, with pharmacies experiencing supply issues with wholesalers, or above the tariff prices."

Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, which represents around 4,000 pharmacies, said: “Pharmacists across the whole of the country are reporting not being able to access stock of antibiotics.

“They go on shift at 4am in the morning to get hold of the stock, only to be told by suppliers there is none available. The Secretary of State for Health has been saying since earlier this week there are no stock issues, yet pharmacies are left on the frontline with no stock.

“We are doing everything we can to help those in need of antibiotics, liaising with prescribers and local NHS teams to seek alternative antibiotics,which are also running short.

“We are also asking that we are given the rights to amend prescriptions to alternative medicines, like we did during the HRT crisis, rather than sending patients back to GPs.”

Symptoms of Strep A include pain when swallowing, fever, and red and swollen tonsils – sometimes with white patches or streaks of pus.

Health secretary Humza Yousaf reassured parents as recently as Thursday, stressing there was “no shortage of supply” of the antibiotics needed to treat strep A.

Speaking on BBC Radio Scotland’s Good Morning Scotland programme, Mr Yousaf said: “I’ve spoken to the Chief Pharmaceutical Officer and had guarantees around the stock and supply, so we’ll keep a close eye on it, but there’s no supply issues on antibiotics.”

UK health secretary Steve Barclay also insisted on Wednesday the level of supply of the necessary antibiotics was “not a concern at the moment”.

But Scottish Labour’s health spokesperson Jackie Baillie stressed "we are hearing one story from both governments on the availability of antibiotics and a very different story from healthcare professionals”.

"People across the UK are struggling to access vital medicine and yet we are being told by Steve Barclay and Humza Yousaf that there is no problem,” she said. “This is clearly not the case, and it is appalling that pharmacists are having to speak out to be taken seriously by the government on this issue.

"These supply chain issues must be fixed immediately, or else patient safety will be put at risk, especially in light of concerns over strep A.”

Ms Baillie added on supply concerns: "It seems to be a problem with the strength of the prescription for very young children. So there are antibiotics, but not the right strength for young children and constituents have had to contact many different pharmacies to try and get a supply."

A Scottish Government spokesperson said: “While there is adequate supply of antibiotics to treat Strep A in the UK, we are seeing a sharp increase in demand for certain types of antibiotics – in particular liquid preparations – in some localised areas because of the recent rise in cases.

“Wholesalers and manufacturers are working at speed to replenish the stock on an ongoing basis and further work is in hand to further strengthen the supply chain resilience.

“In the meantime, doctors and pharmacists have effective alternatives – such as crushing or dissolving solid oral forms of the antibiotics that can be used to treat Strep A, or prescribing alternative ones. As medicine supply is a reserved matter, the health secretary has spoken to the UK Government to seek assurances about the supply of antibiotics.”

A spokesperson from the UK Department of Health and Social Care said: “There is no supplier shortage of antibiotics available to treat Strep A. As the Secretary of State said, we sometimes have surges for products and increased demand means some pharmacies are having difficulties obtaining certain antibiotics.

“We are working urgently with manufacturers and wholesalers to explore what can be done to expedite deliveries and bring forward stock they have to help ensure it gets to where it’s needed.”