Guidance on Shortage of Liquid Formulations of Antibiotics for Paediatrics

There is a shortage of liquid formulations of antibiotics most commonly used in paediatric practice across Canada. The shortage correlates to the widespread surge in respiratory viruses in the country, among other reasons such as supply chain and labour-related challenges.  

The shortage may last several months and has the potential to impact the healthcare system. A shortage disproportionately affects families with fewer resources and low health literacy. In Manitoba, Pharmacy and Child Health leadership are developing options and resources for clinicians and families. CPSM will continue to provide guidance as information becomes available.

CPSM asks registrants to ensure that prescribing practices are evidence-based. Before you prescribe, remember to CONSERVE, APPROPRIATELY PRESCRIBE, and RESTRAIN.

1. CONSERVE Do your part to conserve the antibiotic supply by administering and prescribing antibiotics appropriately.

When prescribing antibiotics, the shortest possible evidence-based effective course should be selected (source: Canadian Paediatric Society – Managing critical drug shortages in clinical practice).

Prescribe doses that can be dispensed in tablet or capsule form. Pharmacists can inform families how to dissolve tablets and capsules; older children should be encouraged to learn how to swallow tablets and capsules.

2. APPROPRIATELY PRESCRIBE Assess your patients for infections that require antibiotic use.

Antibiotics should only be prescribed for clear indications such as:

·         otitis media

·         lobar pneumonia

·         Group A streptococcal pharyngitis 

A note on Virtual Medicine: Acute otitis media, pneumonia, Group A streptococcal pharyngitis, and most urinary tract infections cannot be reliably diagnosed without a physical exam.

The Standard of Practice for Virtual Medicine states the practice of medicine must include timely in-person care when clinically indicated or requested by the patient and any physician providing virtual care must also be able to provide timely in-person care.

3. RESTRAIN from prescribing antibiotics unnecessarily. Most acute respiratory illnesses are viral and do not require antibiotics.  

·         colds

·         influenza

·         influenza-like illness

·         upper respiratory tract infections

CPSM will keep registrants informed on managing drug shortages as information becomes available and will be posted on this page. 

For more information, see the statement from the Canadian Paediatric Society.