Shortage of antibiotics for kids in Quebec result of 'perfect storm'

The antibiotics most commonly prescribed to children in Quebec are in short supply right now, likely due to increased demand after more children than usual became ill this fall.

"We have problems with Clavulin," among other antibiotics, said Pierre-Marc Gervais of the Quebec Pharmacy Owners' Association (QPOA). Clavulin's main active ingredient is a penicillin called amoxicillin.

Amoxicillin is by far the most frequently prescribed medication in the pediatric age group because it covers the most common bacterial infections in kids, like pneumonia and ear infections, according to Dr. Earl Rubin, an infectious diseases specialist at the Montreal Children's Hospital.

"It's really first-line therapy," said Rubin, who added they only heard about the "amoxicillin issue" yesterday.

The QPOA discovered the supply problem about a month and a half ago after examining data they collect on the types of prescriptions filled, and noticing an increase in the number of pediatric antibiotics being prescribed.

When they looked into why the shortage is occurring, manufacturers told them they've stepped up production, Gervais said.

"We did see a disruption in the supply chain…and many of the active ingredients are made in other countries, mainly in Asia, so it takes a little bit more time to get the product into Canada sometimes," he explained.

Gervais and Rubin agree however that the main reason behind the shortages is the "unprecedented surge" in respiratory viruses affecting children in the province.

That's compounded by the over-prescription and inappropriate prescription of antibiotics and also the shortage of certain Tylenol products used by children for the relief of fever and pain said, Rubin.

"You put all of these things together and it's a perfect storm," he said, noting that no matter how much parents want an end to their child's suffering, "antibiotics do nothing for viruses."

"We hear time and time again that parents say, 'I went to the doctor and they say it's viral and there's nothing to do.' Parents are frustrated with that answer but in fact, that is the case," he said.

That medical certainty can also frustrate a doctor when they're faced with a squirming, miserable toddler and parents demanding treatment.

That's when they may prescribe antibiotics anyway, not just to offer some kind of remedy to the family but also because outside of the hospital setting, a doctor does not usually have access to a test that diagnoses a viral illness.

"So it is often difficult to differentiate a virus from something else that's causing the fever," said Rubin.

Historically overprescription was for presumed ear infections, said Rubin, which is a common complication of a virus, but he said more than two-thirds of children over the age of two get better with time alone.

"But you need to give Tylenol and Advil to get them through that time," he said, and there have also been shortages of acetaminophen liquid suspensions used for children in Quebec.

It's not known exactly when the supply will be fully replenished, but Gervais said in the meantime when a pharmacy doesn't have access to a certain antibiotic, they will find a substitute.

"We always try to find solutions," he said.

With files from CTV Montreal's Tania Krywiak.