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UK issues ‘serious shortage’ protocol for penicillin

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The UK has declared a “serious shortage” of three penicillin medicines, enabling pharmacists to prescribe alternative formulations of the antibiotics, after an unexpected rise in cases of Group A Streptococcus pushed up demand.

The Department of Health and Social Care issued “serious shortage protocols” for three liquid solutions of the drug, which are given to children. The bacterial infection, which typically causes mild symptoms including a sore throat or skin rash, has mainly affected school children.

Last week ministers suggested antibiotics could be given as a precaution to pupils if a classmate falls ill with a Strep A infection, as they sought to allay parents’ fears following a number of deaths. So far 16 children across the UK have died after contracting the infection, according to UK Health Security Agency.

Under the measures announced on Thursday, pharmacists will be allowed to supply different types of penicillin — such as a pill — if they have run out of any of the three liquid medicines without returning to the doctor for a new prescription.

Health minister Will Quince said the government was taking “decisive action to address these temporary issues”, including working with drugmakers and wholesalers to speed up deliveries and boost supply as quickly as possible.

The measures were previously used to address shortages in supply of hormone replacement therapy, and were used extensively during the Covid-19 pandemic.

Pharmacists have complained of difficulties in securing supplies of the common antibiotics, including penicillin and amoxicillin, and paying unusually high prices, meaning they were often dispensing the drugs at a loss.

The health department has stressed manufacturers have sufficient supplies of antibiotics and that problems are often localised or restricted to a certain formulation.

Earlier this week, the chief pharmacist stressed that doctors and pharmacists should work together to understand which antibiotics were available locally to try to ease pressure on the supply chain.

Three pharmacies told the Financial Times earlier this week that the minimum they had paid for amoxicillin or penicillin liquid solution from wholesalers, including Alliance Healthcare and AAH, in recent days was £5, which is more than double the amount they will receive in reimbursement under the NHS drug tariff scheme.

On Thursday, one pharmacist showed six more formulations of antibiotics that overnight had become more expensive than the price at which the NHS will reimburse.

The Competition and Markets Authority said on Wednesday that it was probing whether drugmakers were charging excessive prices for antibiotics. The drug watchdog has not yet launched a formal investigation but it said that people had “real concerns” about the cost of antibiotics.

“There should be no doubt that it is illegal for a dominant company to charge excessive prices, or for any companies to collude to drive up prices,” the CMA said.

The UK health security agency has said the unseasonal increase in Strep A infections is not driven by a new strain, and is likely being caused by a rise in circulating bacteria and increased social mixing. Doctors believe children may have failed to build up immunity because of social isolation during Covid-19 pandemic lockdowns.

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