Physicians and patients alike are currently contending with an alarming shortage of commonly prescribed antibiotics, and according to former Food and Drug Administration (FDA) Commissioner Scott Gottlieb, a failure on the part of drug makers to anticipate increased demand, not supply chain problems, is to blame, as The Hill reports.

Amoxicillin, augmentin, and other seemingly ubiquitous antibiotic preparations have been difficult to obtain in recent months, as Axios notes, and the shortages have prompted a host of questions as to the underlying reason for their emergence.

Gottlieb's take

When asked about the situation during an appearance Sunday on CBS' Face the Nation, Gottlieb explained that pharmaceutical companies and distributors had been operating on demand projections based on the past two years, which, due to the COVID-19 precautions that still prevailed during that time period, were lower than what has since proven to be necessary.

According to the former FDA commissioner, “Demand went up this year, they anticipated some increase in demand, but not as much as we're seeing and not this early in the season.”

Gottlieb then emphasized, “So it's not any kind of disruption in supply. This isn't like what we had with baby formula where manufacturers have been taken out of the market,” referencing difficulties faced by parents earlier this year after Abbott Nutrition – one of the country's largest manufacturers of supplemental nutrition for babies – was forced to cease production.

Currently a member of the Pfizer board, Gottlieb tried to assure viewers that the antibiotic shortage is simply a matter of demand temporarily outstripping supply and that the pharmaceutical industry ought to be able to bring things into proper alignment sooner rather than later.

“Supply should catch up with demand, and there are alternatives for things that are in shortage,” Gottlieb added.

“Knock-on effect”

Despite Gottlieb's optimism, however, some healthcare providers are painting a rather different picture of conditions on the ground, during a time of high infection rates with viral illnesses including RSV, flu and covid – as well as secondary bacterial complaints such as ear infections, according to Axios.

Sarah Ash Combs, an emergency physician at Children's National Hospital, told the outlet that there has been something of a domino effect occurring with regard to antibiotics which has caused heightened anxiety among patients and their caregivers alike.

“Basically amoxicillin went on shortage so we upped our game and went to augmentin...and that's now becoming on shortage,” the doctor explained.

“That definitely affects us in the emergency department because these are the types of things we prescribe for kids to go home with and we get calls...with the parent saying, 'I'm at my third pharmacy and they don't have amoxicillin. They don't have augmentin. What do I do?'”

Not just prescription drugs

Axios noted that it is not just prescription antibiotics that have been increasingly hard to come by, as a number of over-the-counter medications such as available supplies of children's Tylenol, Motrin, and other products have become scarce in regions across the country.

The problem in some places has gotten so pronounced that parents in some communities are turning to online chat groups and marketplaces in attempts to secure acetaminophen and ibuprofen, in echoes of the well-publicized searches for baby formula undertaken by frantic moms and dads this spring and summer.

Combs lamented the situation as well, saying that when kids are under the weather parents feel compelled to offer something to ease the pain, and Motrin is often a go-to, and “if I can't even say that, then I really have nothing to do for these children, which makes me feel terrible.”

Worldwide problem

The medication shortage plaguing the United States is also afflicting other parts of the world, according to Politico, with the European Medicines Agency recently initiating a probe into the underlying causes of chronic shortages in almost every member country.

“We are not at the bottom of the root cause yet, but we know that there is an increased demand,” explained the agency's chief medical officer, Steffen Thirstrup, who added that with regard to amoxicillin, “[w]e know from a few of the manufacturers that they have manufacturing capacity issues, some of them related to lack of staff.”

According to the U.K. Independent, the government in Britain has had to issue a second round of emergency rule adjustments to permit pharmacists to offer alternative medications to address a dangerous wave of Strep A infection gripping the population now that commonly prescribed options are in such low supply.

Whether due to a simple imbalance of antibiotic production and demand, lingering supply chain concerns, or other disruptions within the pharmaceutical manufacturing sector, it is clear that this fall and winter are shaping up to be a perfect storm of high infection rates, drug shortages, and waning patience among all those affected.