Strep A antibiotics shortage prompts emergency drugs switch for pharmacists

Pharmacists granted powers to supply alternative penicillin

Fears over a shortage of antibiotics amid a rise in Strep A cases across the UK has lead to an emergency rule change to allow pharmacists to supply alternative penicillin to treat Strep A.

The government announced on Thursday afternoon it had issued Serious Shortage Protocols (SSPs) across the UK for three penicillin medicines due to high demand.

The Department for Health and Social Care (DHSC) hopes the SSPs will help mitigate local supply issues of oral penicillin and allow pharmacists to supply alternative forms of the medicine if they don’t have the specific formulation stated on the prescription.

It comes as 19 children have now died from conditions related to the Strep A bacterial infection in the UK after outbreaks hit a number of schools and left hospital A&E departments “overflowing” with young patients.

The infection has hit the NHS during its busiest period time, with pharmacies struggling with localised shortages of antibiotics – leaving parents struggling to find medicine for their sick children.

By issuing an SSP, pharmacists can now legally supply a specified alternative medicine, removing the need for the patient to return to the prescriber – saving time in GP practices and inconvenience for patients.

To the frustration of parents worried about the health of their child, by law, a pharmacist can normally only supply what is on a prescription presented by a patient. If the medicine isn’t available, the patient must be sent back to the prescriber to get a new prescription for an alternative.

SSPs are a standard procedure, used frequently to manage temporary and potential medicine supply issues. They are a safe and effective way to ensure that medicines continue to be available for everyone who needs them, while saving time for patients, pharmacists and prescribers.

Minister of state for health Will Quince said: “The increased demand for the antibiotics prescribed to treat Strep A has meant some pharmacists have been unable to supply the medicine shown on the prescription.

“These Serious Shortage Protocols will allow pharmacists to supply an alternative form of penicillin, which will make things easier for them, patients, and GPs.”

“We are taking decisive action to address these temporary issues and improve access to these medicines by continuing to work with manufacturers and wholesalers to speed up deliveries, bring forward stock they have to help ensure it gets to where it’s needed, and boost supply to meet demand as quickly as possible.”

Demand for penicillin shot up recently as it is used to treat Strep A and scarlet fever, leaving some pharmacists tackling temporary supply issues. Other issues include not have the specific formulation listed on the prescription.

There are nine other SSPs currently active and have been used to improve patients’ access to Hormone Replacement Therapy drugs and were used extensively during the pandemic.

There are various versions of penicillin – liquid, sugar-free liquid, and tablet - and the SSP issued today will give pharmacists the flexibility to supply an alternative formulation, if they don’t have the one listed in stock.

The SSPs apply to the following medicines: Phenoxymethylpenicillin 250mg/5ml oral solution sugar free, Phenoxymethylpenicillin 250mg/5ml oral solution, Phenoxymethylpenicillin 125mg/5ml oral solution sugar free.

Health authorities say there has been an increase in cases of both scarlet fever and the life-threatening invasive Group A Streptococcal disease (iGAS) this year.

The increase is most likely related to high amounts of circulating bacteria and social mixing, they say.

Most people who come into contact with Strep A bacteria remain well and symptom-free. But in very rare circumstances, the bacteria can get into the bloodstream and cause serious illness (iGAS).

Health authorities are currently investigating the recent increase in Strep A cases, and have been urging parents to be vigilant and stay on the look out for potential symptoms.

The NHS website has more information on the signs and symptoms of Strep A and Scarlet Fever. Visit NHS for more information.