Modena, 9 May 2023 – From at least six months some essential medicines such as the amoxicillin, antibiotic first line in the treatment of the most common bacterial infectionsI am practically unobtainable. For weeks Modena and hospital pharmacies have been completely devoid of pediatric formulations, sachets, syrups and dispersible tablets. This shortage “is taking on the characteristics of a true global health emergency and urgently requires agreed and far-reaching solutions”.
The complaint comes from Italian federation of pediatric doctors (Fimp), by the Cultural Association of Pediatricians (Acp) and by the Italian Society of Pediatrics (Sip) of which Lorenzo Iughetti, director of the Pediatric Clinic of the University Hospital of Modena, is regional secretary. Concerned about the “very serious risk that they are running”, the organizations have appealed to the Italian government and the Italian Medicines Agency “so that efficient initiatives are promptly activated to make up for the shortage of drugs classified as essential”.
Professor Lughetti, why is amoxicillin so important for treatments?
“As indicated by the World Health Organization and by all international guidelines, amoxicillin remains the antibiotic of first choice for all the most common pediatric and adult infectious diseases, since it is an effective, manageable and economical drug “.
What diseases is it used for?
“For example, for pharyngo-tonsillitis, not simple sore throat, but cases in which it also presents with a fever. Then there are also ear infections, sinusitis, community pneumonia”.
Is this antibiotic not available on the market?
“Exactly, production has been lacking for months. The formulation in syrup, used for children when they have this type of disease, is now unavailable even in Modena”.
Have you understood the causes of this shortage?
“There can be many reasons. On the one hand, the pharmaceutical industries no longer find it convenient to produce it. Added to this is also the lack of raw materials for the production of these drugs. Then it must be said that we have just come out of a winter in which there has been a series of important flu phenomena that have meant that in fact the use of antibiotics and antipyretics has been much greater than in previous years and the improper use of antibiotics has increased”.
But is it not possible to use a substitute for this drug?
“The unavailability of amoxicillin currently forces primary care and hospital doctors to prescribe broader-spectrum antibiotics. Second-tier antibiotics that can be equally effective, but easily develop resistance. So the risk is that from next winter we will have many children who will no longer respond to second-line antibiotics. It is a real and very significant problem”.
What can be the solution to solve this emergency?
“First of all, an act of responsibility on the part of the industry would be needed for the production of amoxicillin to resume. Effective and low-cost treatment tools must be made available regardless of any market logic”.
Appeals in this direction are multiplying.
“Yes, the national vice president of the Italian Society of Pediatrics in recent days has proposed to the government to activate the military pharmaceutical plant in Florence which had already been activated during the pandemic to produce some drugs. The situation is very difficult”.
Are there any other indications that you doctors can give?
“We advise parents not to resort to self-medication. Many times, even if in fact the antibiotic is prescribed by the doctor, the parent was able to find amoxicillin in the pharmacy and used it at the first sore throat. The deficiency may be due also to the improper use of this drug, for this reason it must now be used only if prescribed by the doctor”.