No Pink Bubblegum Medicine?
Amoxicillin is one of the most widely prescribed antibiotics pediatricians rely on to treat ear infections, sinus infections, strep throat, and other bacterial infections in their young patients. Yesterday on The PediaBlog, we learned that pharmacies around the country have had a hard time lately keeping amoxicillin suspension — a liquid formulation also known among young kids and pediatricians alike as “The Bubblegum Medicine” or “The Pink Stuff” — in stock.
Four suppliers manufacture practically all of the liquid amoxicillin sold in the United States. The ongoing shortage is due to extreme demand for the antibiotic caused by the spike of illnesses in children infected with respiratory syncytial virus (RSV), influenza, COVID-19, and other respiratory pathogens rather than from kinks in the supply chain.
The good news is that most runny noses, coughs, and sore throats in children don’t need amoxicillin or any other antibiotic to treat them. The American Academy of Pediatrics explains why:
Most childhood infections are caused by viruses. Viruses can make your child feel very sick. If your child has a virus, antibiotics will not help your child feel better or keep others from getting sick.
• The common cold and flu, RSV and COVID-19 are all viruses.
• Most sore throats are caused by viruses, especially when there is also a runny nose or cough.
• Chest colds, even when the cough [or] thick, sticky phlegm or mucus last a long time, are most often caused by viruses. Cigarette smoke and pollution can increase a child’s risk of getting one of these viruses, but bacteria are not usually the cause.
• Most sinus infections (sinusitis) are caused by viruses. The symptoms are a lot of mucus in the nose and post-nasal drip. Most sinus infections will go away on their own without antibiotics. Mucus that is yellow or green does not necessarily mean your child has a bacterial infection.
Because antibiotics like amoxicillin can have unintended side effects (belly pain, diarrhea, vomiting, rashes, and allergic reactions are most common), Pooja Shah sees a reduction of antibiotic resistance as the shortage’s silver lining:
An unforeseen advantage of the shortage is that it forces pediatricians to rule out a viral infection. “We do worry that we may be unnecessarily treating a viral infection with an antibiotic and a silver lining of this shortage and the attention it brings to pediatric care, is to remind us all to be good stewards of prevention of antibiotic resistance by not over-using antibiotics,” Dr. [Hina] Tilab explains.
The AAP identifies situations when the use of antibiotics in children is indicated:
There are some infections that should be treated with antibiotics. Antibiotics may be needed in these situations:
• For infants younger than 3 months old, call your pediatrician for any fever above 100.4° F.
• If your child has been diagnosed with strep throat, based on a rapid strep test or a throat culture. If strep is not diagnosed with a test, antibiotics should not be given. No test is needed if your child has a runny nose and cough with a sore throat. Those are symptoms of a virus.
• If your child’s breathing started to get better and then worse again with new fever or new symptoms. In these cases, your doctor might evaluate your child for bacterial forms of pneumonia or sinusitis.
• If whooping cough (pertussis) is diagnosed.
Fortunately, there is no shortage of other amoxicillin preparations including tablets, capsules, chew tabs (those are pink and taste like bubblegum too!). The AAP says all of them can be used to provide the prescribed dose in children:
Tablets can be split/crushed to mix with any liquid or semisolid, like applesauce. This can be given orally or by tube.
• Capsules can be opened and mixed with any liquid or semisolid, like applesauce. This can be given orally or by tube.
• Chew tabs can be split.
Read about other antibiotic options if amoxicillin suspension is out of stock here.
source http://www.thepediablog.com/2022/12/14/no-pink-bubblegum-medicine/
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