Some products containing a commonly used antibiotic are in short supply, according to Health Canada.
The regulator told Global News on Friday that four companies — Sanis Health Inc., Apotex Inc., GlaxoSmithKline Inc. and Teva Canada Limited — are reporting shortages of drug products containing amoxicillin, an antibiotic commonly used for ear infections and sometimes pneumonia. There are still eight other companies that market amoxicillin products in Canada that are not reporting shortages at this time though, according to the agency’s Drug Product Database.
Health Canada said in its statement that it will follow up with the companies reporting shortages to “assess any potential impacts on the supply of amoxicillin in Canada,” and promises to take action if it becomes aware of supply issues in the country.
“Ensuring that people in Canada have access to the medications they need is a top priority for the Government of Canada,” the agency said.
The reported shortages come as the U.S. Food and Drug Administration also listed a shortage of amoxicillin in an oral powder on Oct. 28. Australia has noted a shortage of the antibiotic, as well.
Dr. Barry Power, the editor-in-chief of the Canadian Pharmacists Association, said that the shortage is an “international issue.” He has heard of the beginnings of shortages of a few children’s antibiotic products in Canada that he said will eventually hit the whole country, and that it is just starting to show at the pharmacy level here.
Power said the raw ingredient of amoxicillin is what is in short supply from the manufacturers often based in China and India, but he doesn’t know the specific reason why there is difficulty in producing it.
“We’re at the mercy of the international market,” he said. “If there’s a shortage on the international market, the domestic manufacturing will be affected.”
Pharmacies haven’t yet reported a shortage of antibiotic products containing amoxicillin, Power said, but some have had to order a different brand because one supplier may not have been able to fulfill the order. He described it as similar to going from one grocery store to another.
Drug companies are required to report shortages, which are publicly listed on a website directed by Health Canada. There are 10 active reported shortages of products containing amoxicillin since Oct. 12, according to the Drug Shortages Canada website, with the reasons listed including “Disruption of the manufacture of the drug,” or “Demand increase for the drug.”
The shortage comes as other drugs have been in short supply in Canada due to high demand, according to Power, especially acetaminophen and ibuprofen for children. Power explained that demand spiked around 300 per cent in August as media reports came out of shortages, surpassing past historic highs in demand. Supply has not been able to catch up with the demand despite an increase in manufacturing by about 30 per cent, Power said, mostly due to capacity limits.
Power said some people are buying more than they need to, and some pharmacists are placing limits on drugs in low supply, though that can be difficult to enforce in the face of concerned parents with sick children.
The supply crunch has come as Canada is entering the flu season, crowds are returning as COVID-19 restrictions have been relaxed and the country’s hospitals are struggling to keep up with intake, creating what Power calls a “perfect storm.”
“Lots of factors have come together to create havoc,” he said.
Dr. Anna Banerji, associate professor of public health at the University of Toronto, illustrated to Global News a potential scenario in which a child with an ear infection in pain who doesn’t have a way to manage that pain might end up at an ER, further adding to the burden they’re facing.
“Having the stress of not having pain and fever medication, not having antibiotics, I think it could be a very stressful time for families and children,” she said.