Hospital Demand for Amoxicillin Increases While Shortage Continues

The ongoing amoxicillin shortage is impacting hospitals and pharmacies across the United States. The FDA officially listed amoxicillin oral powder for suspension in shortage on its website earlier this month. The widely-used antibiotic — particularly for a multitude of pediatric infections — is in short supply from several companies due to increased demand, the agency noted.

New data from healthcare services firm Vizient is showing a 43% surge in demand for all amoxicillin products in the acute care setting from September to October, and a significant 345% spike in demand in October 2022 versus October 2019.

However, fill rates (the percentage of hospital orders that can be fulfilled by suppliers) dropped by 25%, according to data from Vizient members, which encompass more than 60% of the country’s healthcare organizations.

Mittal Sutaria

“The surge in amoxicillin demand is the result of an assumed increase in bacterial infections. It’s been widely reported that cases of respiratory syncytial virus (RSV) in pediatric patients are up significantly this year,” Mittal Sutaria, senior vice president of contract and program services at Vizient, told Formulary Watch.

Cases of influenza have also been steadily increasing in October, with a 9% positivity rate reported by the CDC and a 4% increase in visits to a healthcare provider for respiratory illness, Sutaria added. In addition, nearly 66% of pharmacies are having challenges obtaining amoxicillin, according to a new National Community Pharmacists Association survey of 8,000 pharmacy owners and managers, while 89% are realizing a shortage of Adderall.

Sandoz, for example, has limited or no availability for almost all formulations of amoxicillin, the FDA reported, while Aurobindo USA and Teva have product “on allocation.”

ASHP’s Drug Shortages site lists numerous formulations of amoxicillin in shortage from Aurobindo, Hikma, Sandoz, Rising, and Teva. However, Rising has amoxicillin capsules and tablets available, according to ASHP.

Sandoz is “currently facing a significant demand uptake resulting in a supply situation for some of our Sandoz antibiotic medicines (amoxicillin, amoxicillin/clavulanic acid) in the United States, Canada and selected European markets,” Leslie Pott, vice president of communications for Sandoz US, told Formulary Watch.

“At the moment we are able to meet historical demand for our antibiotics, but we are facing challenges to meet this sudden spike in demand now that the flu season is in full swing,” Pott said.

While Sandoz is not able to give an estimated timeframe on when amoxicillin will be re-stocked, “we remain confident in our ability to supply these critical medicines long term and are on track to strengthen the supply reliability of our antibiotics currently low in stock,” Pott said.

According to ASHP, most of the products are expected to return to normal levels by the end of this year or in early January.