Key TakeawaysCases of respiratory viral infections are soaring, straining pediatric hospitals nationwide.Due to surging demand, key medications such as Tamiflu and amoxicillin are in active shortage.Patients who cannot find certain medications can speak with a pharmacist or health provider to adjust the dosage of an available form of the drug or to find a suitable alternative.

Key Takeaways

Cases of respiratory viral infections are soaring, straining pediatric hospitals nationwide.Due to surging demand, key medications such as Tamiflu and amoxicillin are in active shortage.Patients who cannot find certain medications can speak with a pharmacist or health provider to adjust the dosage of an available form of the drug or to find a suitable alternative.

Anyone can report a drug shortage to the ASHP, and pharmacists from the University of Utah verify the reports with drug manufacturers.

Prescription fills for Tamiflu are far outpacing the 10-year average for this time last year, according to the healthcare companyGoodRx.

Similarly, the pediatric versions of amoxicillin are nearly out of stock, saidMichael Ganio, PharmD, senior director of pharmacy practice and quality at ASHP.

What the Amoxicillin Shortage Means for Parents and Children

Pediatric hospitals already strained from the impact of the COVID-19 pandemic are now struggling to care for children sick with other respiratory viruses. More than 6% of outpatient visits are for flu last week—that’s three times the rate at the same time last year, according to the Centers for Disease Control and Prevention.

The flu season is just getting underway, but there are already 2.5 times as many cases as at the same time last year. And in the past month, about 17% of RSV tests were positive, compared to 7% at the same time last year.

“Classically, flu doesn’t peak until January or February. We’re not even there yet. We have no clue what’s going to happen with RSV because it’s not behaving like it ever has before,”Stanley Spinner, MD,Chief Medical Officer at Texas Children’s Pediatrics and Texas Children’s Urgent Care, told Verywell.

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What Are Some Alternatives to Tamiflu?

Tamiflu can help decrease the duration and severity of flu symptoms for a day or two when given within two days of exposure or symptoms appearing. Spinner said that while it’s useful for alleviating symptoms in people at risk for more severe outcomes of flu, it’s not necessary for most healthy people.

Other antivirals can be used in lieu of Tamiflu. Those alternatives, which include Relenza (zanamivir), Rapivab (peramivir), and Xofluza (baloxavir marboxil), appear to be available.

However, Xofluza is still on patent so caregivers may face insurance issues. Relenza requires a different inhalation technique and is not available in generic forms.

Why Is Amoxicillin Also in Shortage?

As with viral infections, bacterial infections become more common in colder months. These include strep throat and sinus and ear infections. Amoxicillin is an antibiotic, meaning it can be used to treat those common bacterial infections, but won’t be effective against viruses, like influenza and RSV.

When providers are overwhelmed with patients, they may prescribe antibiotics for a viral infection rather than take the time to explain the differences in treatments to patients, even though this is poor practice, Spinner said.

Antibiotics for Upper Respiratory Infections

“There has always been parental pressure on physicians to prescribe antibiotics for kids when they have respiratory infections, even when they may be viral,” he said.

Getting an accurate diagnosis is important to ensuring that a sick individual is getting effective treatment.

“There’s often difficulty in making a diagnosis, particularly over the phone. Pediatricians and hospitals are being overwhelmed, so telemedicine might be the only option for a parent or caregiver to care for their child. And if that’s the case, it may be difficult to rule out a bacterial infection versus RSV or flu,” Ganio said.

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But Ganio cautioned that there is no data directly matching prescriptions to diagnoses, so it’s hard to know if inappropriate prescribing is a significant driver of the current shortage.

Albuterol is a drug that can open up the airways, easing some of the symptoms of RSV and flu. There’s a shortage of the version that’s used in hospitals, but the self-administered inhaled version, which is given in outpatient settings, is still in ample supply.

How to Get Treatment and Stay Healthy This Season

The Food and Drug Administration said the shortages would likely last through the coming months.

All the same mitigation strategies that work to protect against COVID-19 will also work against other respiratory illnesses.

“The best thing you can do is to teach your children that washing your hands is incredibly important. It always has been,” Spinner said.

Avoiding crowded indoor spaces when possible, wearing a well-fitting mask, and getting tested at the first sign of illness can also reduce the risk of getting and sharing a virus. For caregivers of children, Spinner said to keep kids at home when they display signs of sickness and encourage them to stay hydrated when ill.

Patients who are having a hard time finding their typical medication can speak with a pharmacist or health provider to adjust the dosage of an available form of the drug or to find a suitable alternative.

“There’s a shortage of pharmacy technicians and the pharmacy workforce is being strained right now,” Ganio said. “I know it’s not a great time if you’re a parent or caregiver of a sick child, but just try to be patient and work with the pharmacy and the provider to find that next best option, understanding that there are a lot of other priorities at the moment, too.”

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What This Means For YouIf you need medication for a viral or bacterial infection that is out of stock at your pharmacy, talk to your doctor or pharmacist about whether there is an alternative that will work for you. They may suggest an alternative prescription or lower the dosage of an adult version of the drug.

What This Means For You

If you need medication for a viral or bacterial infection that is out of stock at your pharmacy, talk to your doctor or pharmacist about whether there is an alternative that will work for you. They may suggest an alternative prescription or lower the dosage of an adult version of the drug.

3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.FluServ-NET: national, regional, and state level outpatient illness and viral surveillance.Centers for Disease Control and Prevention.RSV National Trends.Smith MJ, Wattles BA.Appropriate antibiotic prescribing—the safer and less expensive choice.JAMA Netw Open. 2022;5(5):e2214160. doi:10.1001/jamanetworkopen.2022.14160

3 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.FluServ-NET: national, regional, and state level outpatient illness and viral surveillance.Centers for Disease Control and Prevention.RSV National Trends.Smith MJ, Wattles BA.Appropriate antibiotic prescribing—the safer and less expensive choice.JAMA Netw Open. 2022;5(5):e2214160. doi:10.1001/jamanetworkopen.2022.14160

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Centers for Disease Control and Prevention.FluServ-NET: national, regional, and state level outpatient illness and viral surveillance.Centers for Disease Control and Prevention.RSV National Trends.Smith MJ, Wattles BA.Appropriate antibiotic prescribing—the safer and less expensive choice.JAMA Netw Open. 2022;5(5):e2214160. doi:10.1001/jamanetworkopen.2022.14160

Centers for Disease Control and Prevention.FluServ-NET: national, regional, and state level outpatient illness and viral surveillance.

Centers for Disease Control and Prevention.RSV National Trends.

Smith MJ, Wattles BA.Appropriate antibiotic prescribing—the safer and less expensive choice.JAMA Netw Open. 2022;5(5):e2214160. doi:10.1001/jamanetworkopen.2022.14160

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