It is nearly two weeks since the Scottish Government issued a supply alert notice for drugs used to treat the infection, with pharmacists advised the antibiotics may be “temporarily in limited supply” for several weeks due to a surge in demand. But since then, the pharmacy and medicines division of the government’s chief medical officer directorate has published eight further notices for the attention of pharmacists and GPs. Known as ‘serious shortage protocols’, the notices alert health professionals to supply problems with a popular type of penicillin.
It comes almost three weeks after health secretary Humza Yousaf reassured parents there was “no shortage of supply” of antibiotics needed to treat Strep A.
On December 15, First Minister Nicola Sturgeon told Holyrood she was aware of “some localised supply problems” with penicillin and amoxicillin liquid preparations due to the increase in demand across the whole of the UK, but stressed such demand-led shortages were “not uncommon”.
However, some parents have reported travelling to as many as eight different pharmacies in an attempt to secure antibiotics for their children, with shortages reported across the country. NHS Greater Glasgow and Clyde, Scotland’s largest health board, has also reported “significant shortages” of antibiotics, with availabililty changing on a daily basis.
The notices stress the shortages of phenoxymethylpenicillin could be in place until January 31, 2023, and advise pharmacists to prescribe other drugs, such as amoxicillin or flucloxacillin, where possible. The serious shortage protocol applies to five prescribed versions of phenoxymethylpenicillin. They include tablets as well as oral solutions, which are commonly prescribed for children. The notices, issued before Christmas, state the restrictions are in place to manage stock supplies “fairly and effectively”.
The notices, signed by Alison Strath, chief pharmaceutical officer for Scotland, add that where alternatives are unavailable, “broader spectrum antibiotics with increased risks of side effects and antimicrobial resistance” may be used. They include cefalexin and co-amoxiclav.
The same protocols have also been issued at a UK-wide level, allowing pharmacists to legally supply specified alternative medicines. The Royal Pharmaceutical Society has said while the serious shortage protocols are a short term measure that should help “ease” the situation, pharmacists regard them as “bureaucratic and inflexible” tools.
According to figures provided by the UK Health Security Agency, 94 people in England, including 21 children, have died after contracting Strep A this winter. There have been no confirmed fatalities in Scotland over the same period.
The most recent data from Public Health Scotland shows there were 865 laboratory reports of group A streptococcus (GAS) in the week ending December 18. While that figure is down from 1,266 the previous week, it remains considerably higher than previous peaks observed over the past six years, when the number stood at between 300 and 480 reports a week.