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A drug shortage is making it harder for doctors to treat strep throat


Strep throat, the bacterial infection that typically causes a sore throat, seems to be everywhere these days. It can affect adults, but it's most common in school-age children. And it's treated with antibiotics, typically amoxicillin, but that's proving more difficult these days because there's a nationwide amoxicillin shortage. NPR pharmaceuticals correspondent Sydney Lupkin is here to talk to us about that. Hi, Sydney.


RASCOE: So let's start with what's going on with strep. Like, is this season actually worse than normal?

LUPKIN: It is, unfortunately. We don't have exact numbers of cases because the Centers for Disease Control and Prevention doesn't actually track run-of-the-mill strep infections, but strep activity is higher these days. Here's what Caitlin Rivers told me. She's an epidemiologist at Johns Hopkins Center for Health Security.

CAITLIN RIVERS: This whole winter season has been really tough for the common pathogens that keep us out of school and out of work, and strep throat is one that has really been going around.

LUPKIN: Now, the CDC does track a certain kind of strep called invasive group A strep. Invasive strep means instead of the bacteria staying in the throat, it goes to other parts of the body, so it can get in the bloodstream and cause a rash. And after two years of record low cases of this kind of strep during the height of the pandemic, those cases are actually higher than usual this season. Regardless of what kind of strep someone has, though, strep infections need to be treated with antibiotics. So a shortage of amoxicillin is making things really tricky for families, and that actually hit home for Caitlin Rivers late last year when both of her kids had strep.

RIVERS: We had to visit several pharmacies to find the medication that we needed. And so it just adds another burden on what's already been a really difficult winter respiratory season for families.

RASCOE: That's, like, super frustrating. You know, like - and I got three kids and, you know, they get sick all the time. And so these type of shortages are, like, a little scary. Like, how big a deal is this?

LUPKIN: Well, it's been going on for a while now. The FDA added it to its list of drug shortages in October of last year, and there are still amoxicillin products that aren't available. So this shortage is limited to the pediatric versions of amoxicillin, so, like, liquid products that are easier for kids to take as opposed to pills. And, like, you'll remember - or as a mom, you'll know - this is the pink stuff that you...

RASCOE: Yes, that my kids have had to take when they had, like, the flu or whatever, something. Yeah.

LUPKIN: And the shortage is affecting multiple brands, but it's not every product. So pharmacists and doctors have options. I talked to Erin Fox, who's a national expert on drug shortages at the University of Utah, and she says the issue is that a really popular strength of amoxicillin is what's not available.

ERIN FOX: You might need to switch. So you might have to take a little bit more volume, which I have given children antibiotics, and I know that that is not fun.

LUPKIN: She says parents might need to call around if their pharmacy doesn't have what they need.

RASCOE: OK, but - so what is actually causing the shortage?

LUPKIN: So some companies have said this is a demand issue, and that means that there are more people who need it than what's available. Here's Erin Fox again.

FOX: Companies typically look to see what their sales were the prior year. They might make a little bit of an adjustment. But with the really severe respiratory season we've had this year, it just simply was a mismatch between what people manufactured and what was available.

LUPKIN: However, under current rules and regulations, drugmakers actually don't have to tell the public why something's in shortage, and not all of the companies that make this have explained themselves. But based on what those few companies have said, it doesn't seem to be that this is a problem with manufacturing or contamination or anything like that, and that means that they can hopefully get the forecast right for next year.

RASCOE: But for this year, what about what's happening now in all the cases of strep that are going around?

LUPKIN: So the good news about strep that it has a season. Usually, that's from December to April. So we could be at the tail end of it, though epidemiologist Caitlin Rivers pointed out that the pandemic has thrown the regular winter illness patterns off a little bit, so it could go a little bit longer.

RASCOE: Well, that's not great news, but, you know, we'll see. That was NPR pharmaceuticals correspondent Sydney Lupkin. Thank you so much, Sydney.

LUPKIN: You bet. Transcript provided by NPR, Copyright NPR.

Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.
Sydney Lupkin is the pharmaceuticals correspondent for NPR.

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