Do you have a sick child? Some drug shortages can make treatment difficult

Shortages of some key pediatric drugs are making the particularly difficult respiratory disease season even more difficult in Alberta.

An ongoing shortage of children’s acetaminophen and ibuprofen products, including pediatric Tylenol and Advil, continues across the country due to what Health Canada calls “unprecedented demand.”

And amoxicillin, a first-line antibiotic used to treat many common bacterial infections, is now also in short supply.

“It’s a horrible time,” said David Brewerton, pharmacy manager of Lukes Drug Mart in Calgary’s Bridgeland neighborhood.

As more Alberta children fall ill, her pharmacy can no longer fill its shelves.

Children’s Advil and Tylenol have been in short supply for months.

“There just aren’t any,” said Brewerton, who answers hourly calls from parents desperate to find any. The few bottles he has been able to order recently from suppliers do not last.

“The demand is so great that it just disappears into a black hole because it’s tearing itself away so quickly.”

David Brewerton, director of pharmacy at Lukes Drug Mart in Calgary, faces continued shortages of children’s Advil and Tylenol as well as the pediatric formulation of amoxicillin. (Jennifer Lee/CBC)

Antibiotic in short supply

And Brewerton also can’t get his hands on certain forms of the antibiotic, amoxicillin.

“On the adult side it’s fine, but on the pediatric side there’s none available. I’ve searched…and there’s no suspension available, not even chewable tablets are available “, did he declare.

“We can’t order it. We can’t get it.”

Amoxicillin is a key treatment for many bacterial infections, according to Mathieu Giroux, director of pharmacy at Cambrian Pharmacy in Calgary.

“Amoxicillin is generally…our first-line treatment for virtually all respiratory illnesses, and that is why [we have] the shortage, and that’s what caused an increase in demand,” he said.

“So from ear infection to pneumonia, it’s usually always our first line.”

Pharmacy manager Mathieu Giroux of Cambrian Pharmacy says amoxicillin is a first-line treatment for many common bacterial infections. The pediatric formulation of the antibiotic is rare. (Cambrian Pharmacy)

According to Giroux, when a first-line drug becomes scarce, it forces doctors and pharmacists to turn to other antibiotics that may have more side effects.

“And his [these] antibiotics that we like to keep second and third line, so there are other options in case of resistance,” he said.

“So it’s not an ideal situation.”

According to Health Canada, four of the 12 pharmaceutical companies that market amoxicillin products in Canada are reporting shortages of various formulations.

Giroux said it’s more complicated, but compounding pharmacies like his can still make the pediatric formulation.

According to the Alberta College of Pharmacy, compounding pharmacies can also make pediatric versions of fever and pain medications.

And, as a temporary measure to minimize supply disruptions, the college said pharmacies can also repack children’s non-prescription painkillers from bulk supplies, if available.

“Parents are encouraged to check with their pharmacy team for the availability of repackaged or compound non-prescription children’s pain relievers containing acetaminophen,” spokesman Barry Strader said in a statement.

Hospital supply

Meanwhile, Health Canada said it is aware that the supply of pediatric acetaminophen and ibuprofen products remains limited in pharmacies and hospitals in various parts of the country.

He issued a public notice in October.

“Supply of these products has been limited primarily due to unprecedented demand since the summer,” a spokesperson said in a statement shared with CBC News.

Canada is import supplies from Australia and the United States which will be distributed to hospitals across the country.

Alberta Health Services is monitoring the shortage and said it is not affecting patients in Alberta hospitals at this time.

It uses compound pain relief products when supplies are unavailable and sometimes turns to other medications, spokesperson Kerry Williamson said in an emailed statement.

“Our provincial pharmacy team monitors drug stock inventories and coordinates the movement of stock to sites that need it most for the duration of a drug shortage,” he added.

As hospitals find ways to cope, some patients end up in the emergency room due to supply issues in the community.

“I see patients in the ER where parents say they couldn’t get their hands on them. [these medications]. And that’s probably what drives some of the ER visits. But that’s not the main factor,” said Dr. Stephen Freedman, professor of pediatrics and emergency medicine at the University of Calgary.

“We’ve had supply chain issues a number of times in the past and we really need to work to ease the strain and stress on the system so it’s better able to handle these peaks in demand…especially in the pediatric field.

Freedman noted that children under 10 generally need liquid medications and that there aren’t as many companies making these products.

“And when there are fewer providers, it leads to greater consequences.”

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