Have a sick kid? Some medication shortages may make treating them tricky

Shortages of some key pediatric medications are making a particularly rough respiratory illness season even tougher in Alberta.

An ongoing shortage of children's acetaminophen and ibuprofen products, including pediatric Tylenol and Advil, continues across the country due to what Health Canada calls "unprecedented demand."

And amoxicillin, a first-line antibiotic used to treat many common bacterial infections, is now in short supply as well.

"It's horrible timing," said David Brewerton, pharmacy manager at Lukes Drug Mart in Calgary's Bridgeland neighbourhood.

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As more and more Alberta children fall ill, his pharmacy can't keep its shelves stocked.

Children's Advil and Tylenol have been scarce for months.

"There just is none," said Brewerton, who is fielding hourly calls from parents desperate to track some down. The few bottles he has been able to order recently through suppliers don't last.

"The demand is so great that it just disappears into a black hole because it gets snapped up so fast."

Antibiotic in short supply

And Brewerton also can't get his hands on some forms of the antibiotic, amoxicillin.

"On the adult side, we're OK, but on the pediatric side, there's none available. I looked it up … and there is no suspension available, not even the chewable tablets are available," he said.

"We can't order it. We can't get it."

Amoxicillin is a key treatment for many bacterial infections, according to Mathieu Giroux, pharmacy manager at Calgary's Cambrian Pharmacy.

"Amoxicillin is usually … our first-line treatment for pretty much any respiratory illness, and that's why [we have] the shortage, and that's what's been causing a surge in demand," he said.

"So from ear infection to pneumonia, it's usually always our first line."

According to Giroux, when a first-line drug is in short supply, it forces doctors and pharmacists to turn to other antibiotics that can have more side-effects.

"And it's [these] antibiotics that we like to keep as second and third line so there's other options if there is resistance," he said.

"So it's not an ideal situation."

According to Health Canada, four of 12 pharmaceutical companies that market amoxicillin products in Canada are reporting shortages of various formulations.

Giroux said it's more complicated but compounding pharmacies like his can still make the pediatric formulation.

Compounding pharmacies can also make pediatric versions of fever and pain relief medications, according to the Alberta College of Pharmacy.

And, as a temporary measure to minimize supply disruptions, the college said pharmacies may also repackage children's non-prescription pain relievers from bulk supplies if available.

"Parents are encouraged to check with their pharmacy team about the availability of repackaged or compounded non-prescription children's pain relievers containing acetaminophen," spokesperson Barry Strader said in a statement.

Hospital supply

Meanwhile, Health Canada said it is aware that supplies of pediatric acetaminophen and ibuprofen products remain limited in pharmacies and hospitals in various parts of the country.

It issued a public advisory in October.

"Supply of these products has been limited primarily due to unprecedented demand since the summer," a spokesperson said in a statement shared with CBC News.

Canada is importing supplies from Australia and the United States that will be distributed to hospitals around the country.

Alberta Health Services is monitoring shortage and said it is not impacting patients in Alberta hospitals at this time.

It's using compounded pain relief products when supply is not available and turning to other drugs at times as well, spokesperson Kerry Williamson said in an emailed statement.

"Our provincial pharmacy team has oversight of medication stock inventories and co-ordinates the movement of stock to sites in greatest need for the duration of a drug shortage," he added.

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While hospitals are finding ways to cope, some patients are ending up in the ER due to supply issues in the community.

"I do see some patients in the emergency department where the parents will state they couldn't get their hands on [these medications]. And that probably is driving some of the emergency department visits. But that is not the biggest driver," said Dr. Stephen Freedman, a professor of pediatrics and emergency medicine at the University of Calgary.

"We've had supply chain issues many times in the past and we need to really work to alleviate the strain and stress on the system so it's more able to handle these demand spikes … especially in the pediatric realm."

Freedman noted that children under 10 generally need liquid medications and there aren't as many companies making those products.

"And when there's fewer suppliers, that does lead to greater consequences."