Why is the UK facing antibiotic shortage amid deadly bacteria contagion?

Parents in the United Kingdom are scrambling to find medicines for their sick children amid a surge in bacterial infections and a shortage of antibiotics. 

In the past few weeks, pharmacies in many cities in the UK have turned away customers looking for amoxicillin and penicillin – both common antibiotics. 

The shortage has emerged at a time when the UK health authorities have recorded 16 deaths of children under the age of 15 since September due to an invasive strain of strep A infection. 

Strep (streptococcal) A is usually a mild bacterial infection which makes thousands of people sick every year. Generally, it is associated with strep throat (tonsillitis) and scarlet fever. But at times, it develops into deadly Group A Strep (iGAS) if the microbes enter the bloodstream. 

Doctors have watched with concern as the number of Strep A cases has surged at this time of the year, making children sick earlier than the usual onset of the infections in the winter season. 

While authorities are still investigating the reasons, experts say that it could be linked to the Covid-related lockdowns. 

During the pandemic restrictions, kids didn’t have a lot of interaction with each other and some of them are just getting exposed to infections against which they haven’t developed strong immunity. 

The contagious disease can easily spread by close contact, sneezing or coughing in close proximity, making authorities particularly concerned about the schools where pupils have been diagnosed. 

“To my knowledge, we’ve never seen a peak like this at this time of year, at least not for decades,” Shiranee Sriskandan, a microbiologist at Imperial College London, told Nature, last week. 

Pathogens like iGAS can quickly develop antimicrobial resistance, which the World Health Organization (WHO) says has become a global problem due to the rise in the use of antibiotics. 

However, UK authorities say they haven’t found any evidence to suggest any new strain of iGAS doing the rounds. 

But British parents are visiting multiple pharmacies to find medicines for their children.

The pharmacists say they need to get the supply from wholesalers and drug manufacturers who have been accused of price-gouging behaviour amid the strep A scare. 

Besides the shortage, pharmacies complain they are taking a financial hit as they sell antibiotics at a discount but the National Health Services (NHS), the UK state-run health provider, is reimbursing a fraction of the drug’s price. 

Retailers say wrong messaging by the authorities after publicly announcing that there’s no shortage of penicillin and amoxicillin has fanned tensions in the country. Desparate customers lock horns with chemists--even resort to violence-- seeking access to these medicines.

David Webb, the chief pharmaceutical officer at NHS, said last week that there was no shortage of the drugs at the national level. 

Some antibiotics “may be in limited supply at certain wholesalers and pharmacies” due to a surge in demand, he said. 

Prices for capsules and oral mixtures of penicillin and amoxicillin have more than doubled from $4 to $5 to $12 to $18, according to The Times. 

A generic drug, amoxicillin (sold as Augmentin in many countries) should have been easily available. Instead, its shortage and high prices have brought big pharma companies under the spotlight.

A global fallout 

In recent months, the shortage of antibiotics, including amoxicillin, has been reported in the US, France, Belgium and Italy. 

For years, health experts have pointed out that big pharmaceutical companies are not investing in developing a new generation of antibiotics. 

Amoxicillin has been around for more than 45 years. Since patents no longer protect the drug, big companies see no incentive to shoring up their production. 

Complex pharmaceutical supply chains spread across different parts of the world, where chemical ingredients come from one country and packaging is done elsewhere, have added to the health crisis in the UK. 

Most of the world’s Active Pharmaceutical Ingredients (API), the chemical compounds in medicines, come from China and India. China has imposed strict Covid-related lockdowns. 

The ongoing antibiotic shortage has put this aspect of the supply chain in the spotlight and there is already debate on bringing production back to Europe.