iGAS: David Webb asks pharmacies to order antibiotics ‘sensibly’

With  higher than usual number of cases of scarlet fever, caused by invasive Group A streptococci (iGAS) infections being reported in children across the country, Chief Pharmaceutical Officer for England David Webb has assured pharmacies of sufficient supply of antibiotics.

In a letter, shared by the PDA, Webb also urged the pharmacies to order antibiotic stocks sensibly.

“Local pharmacy teams may be experiencing a temporary interruption of supply of some relevant antibiotics due to increased demand. On a national level, sufficient stock exists for the NHS,” he said.

He said NHS is working closely with the Department of Health and Social Care (DHSC) and has taken actions to help ensure medicines continue to be available.

He explained that the supplies of antibiotics for the treatment of Group A Strep, particularly phenoxymethylpenicillin presentations, have seen a surge in demand, leading to potential constraints at certain wholesalers and pharmacies,

“Supplies are readily available with manufacturers and deliveries into wholesalers and pharmacies are being expedited and are expected in the coming days,” he added.

Where antibiotic therapy is required for the treatment of suspected GAS infection, he asked prescribers and local pharmacy teams to “work together to understand availability of antibiotics locally and order antibiotic stocks sensibly, in line with patient demand,” ensuring that excessive quantities are not ordered to avoid more pressure on the supply chain.

He also urged pharmacy teams to reassure worried parents and carers, as well as patients, and display the guidance available at NHS website prominently on site.

In a statement today (9 December), the RPS has also noted that pharmacists and teams are working hard to resolve stock issues around antibiotics.

“The situation around rising cases of Strep A and obtaining antibiotics has been challenging for patients, parents and carers, pharmacists and all those in our health system working to help patients,” Professor Claire Anderson, RPS president, and Thorrun Govind, Andrew Carruthers and Cheryl Way, chairs of the body in England, Scotland and Wales respectively, said in a joint statement.

“Thank you to all pharmacists and pharmacy technicians working hard to resolve stock issues around antibiotics needed to treat Strep A. We know you’re under enormous pressure and doing everything you can to keep patients well. Your professionalism in the face of adversity and determination to put patients first is always inspiring but we recognize often comes at a personal cost to your wellbeing.

“We are in contact with the NHS and governments across Great Britain and doing all we can to support you to help patients. The situation is under constant review and the aim of everyone is to ensure patients get access to the medicines they need.”

Earlier, PSNC has said that its Dispensing and Supply Team has received reports from some contractors and pharmacy teams who are finding it difficult to obtain certain antibiotics.

“Pharmacy teams are reporting that there is little or no stock of liquid amoxicillin and phenoxymethylpenicillin (Pen V) showing at wholesalers, and that the supply challenges have now extended to other oral antibiotics too. PSNC is also monitoring prices for these medicines and is seeking concessionary prices based on reports received from contractors,” it said.

The Healthcare Distribution Association has confirmed that the huge spike in demand for several antibiotics, adding that its members are working hard with manufacturers to increase supply to meet this unprecedented demand.

On Wednesday, Alliance Healthcare issued the following update: “Working with the healthcare industry Alliance Healthcare works closely with manufacturers to ensure maximum supply of product to UK patients. Demand has been high across our antibiotics range recently and despite generally good supply levels, we are experiencing some short-term impact as a result, however more replenishment is on the way. We ask that our customers only buy what they need and continue to regularly check myahportal.co.uk for the most up to date stock availability information.”

Misinformation

Meanwhile, the PSNC has flagged some misinformation that has been spreading on social media about the help that community pharmacies can provide.

A suggestion has been made that pharmacies can test for strep A and hand out antibiotics, but this is not an NHS service and is only provided by a small number of pharmacies privately and under specific PGDs or where independent prescribers are available, it noted.

“PSNC is pushing DHSC and NHS England to address these misconceptions and put out clear communications on where parents should go for help and where pharmacy teams should direct people to,” the organization said.

PSNC asked pharmacies to make use of the social media resources developed by the UKHSA, available to download from the DHSC campaign resources center, to raise awareness amongst the public.

It also highlighted the guide published by the Specialist Pharmacy Service (SPS) on using solid oral dosage form antibiotics in children, including use for Group A streptococcal infections.