Strep A: Manchester pharmacist discusses supply issues

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Pharmacists have issued a warning regarding drug shortages as demand for penicillin and amoxicillin has skyrocketed in recent days, as the number of cases of Strep A has risen among children.

One prescriber says they are “now completely out of certain antibiotics and having to turn unwell children away”. 

The government has insisted that there are no shortages of antibiotics. However, pharmacists have said that there are supply chain issues since the need for the drugs shot up. Some 15 children have now died in recent months from a severe form of Strep A illness.

Yesterday, the Manchester Evening News reported how parents faced a ‘nightmare’ trying to get hold of antibiotics for their poorly children.

“It’s like a boiling pot and it’s been ongoing for a number of months. This situation with antibiotics is the straw that broke the camel’s back,” said Zeshan Rehmani, an advanced clinical practice pharmacist and director of Manchester Pharmacy and Health Clinic.

“We can’t keep going on like this, we will see increased mortality in children and adults. Today, I’m struggling to get any antibiotics but there’s so many patients coming in.

“I had a young girl who was autistic, five years old, come into my pharmacy with a Strep A throat infection and we haven’t got the antibiotics in. Her father is now going from pharmacy to pharmacy to find the right antibiotics for his daughter.”

The pharmacist says he and others are calling doctors to plead with them to alter prescriptions based on the stocks available. Making matters worse, drugs including penicillin that cost £1 at the start of the month, are now £10-a-bottle for pharmacists to order, claims Zeshan.

The pharmacist says there are regular worries that the government will not reimburse pharmacies for the inflated prices, where they would normally cover the cost of these medications.

“All of this while the Department of Health says there’s no shortages,” he continued. “Do I hold off and not order the medications because I will make a loss and have to pay out of my own pocket for these medicines? We are struggling to keep afloat every month, but I don’t have the heart to turn patients away and see them struggling.”

Last week, Prime Minister Rishi Sunak assured MPs during PMQs that there is no shortage. “[Strep A] can be treated appropriately with antibiotics, there are no current shortages … and there are well-established procedures to ensure that remains the case,” he told the Commons.

He added that there is “no reason to believe” it has become more lethal or more resistant to antibiotics, and is not a new strain.

But Luvjit Kandula, a pharmacist and chair of the Community Pharmacy Provider Board in Greater Manchester, has said supply chain issues following the intense demand are to blame.

“There have been reports from community pharmacies, nationally not just in Greater Manchester, that there has been intermittent supply and some pharmacies reporting difficulties getting hold of stock,” she told the M.E.N during a live interview on their Facebook page. “These issues have been escalated to the national team and we work with Dr Manisha Kumar [Greater Manchester’s chief medical officer] and other colleagues locally.

“The answer for you is that the demand has been so high that it has outstripped supply. What we understand from the national team is that there’s not a shortage of antibiotics, there’s just a bit of a delay of those antibiotics coming down the supply chain. Unfortunately pharmacies are the last port of call so we’re the ones in front of the patients having to deal with those difficult situations. But we have been provided assurance from the national team that this situation should start to resolve in the next couple of days.”

The pharmacy leader said the situation is being reviewed daily in Greater Manchester. 

National chains have also admitted to declining supplies. Asda chairman Stuart Rose says the supply of antibiotics in their pharmacies to treat Step A is “thinner” than he’d prefer. Speaking on Sunday with Laura Kuenssberg, he said that while they’re “coping,” there is a shortage. In response to Kuenssberg’s question about their stock levels, he said: “I think the answer would be that we’re thinner than we’d like.”

Continuing, he said: “We need to make sure that people are reassured that those stocks are available, but we’ll get through it.”

However, some national chains are claiming they still have stocks of the drugs. A Boots pharmacy spokesperson said: “There is enough amoxicillin suspension, penicillin suspension and related antibiotics across the UK, and availability at Boots pharmacies is generally very good. There are a very small number stores waiting for stock; our online Prescription Stock Checker helps you to find the closest Boots to you that has the medicines you need.”

A Department of Health and Social Care spokesperson said: “There is no supplier shortage of antibiotics available to treat Strep A. We sometimes have surges for products and increased demand means some pharmacies are having difficulties obtaining certain antibiotics.

“We rely on competition to drive down the prices of generic medicines which generally results in lower prices for the NHS – this means prices can fluctuate, but no company should use this as an opportunity to exploit the NHS.

“Where companies are found to be abusing their dominant position by charging excessive and unfair prices, the Competition and Markets Authority (CMA) can take action against businesses and individuals engaged in anti-competitive conduct.”

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