AAP recommends antibiotic alternatives during amoxicillin shortage

As the national amoxicillin shortage worsens, the American Academy of Pediatrics released a guidance Nov. 21 detailing its recommendations for alternative therapies. 

The priority should be amoxicillin formulations that have not been affected by the shortage, such as 500 milligram and 875 milligram tablets, 250 milligram and 500 milligram capsules and 250 milligram chew tabs, according to the AAP. The organization added that tablets and capsules can be crushed and mixed with food "like applesauce."

For acute otitis media, an infection in the middle ear, the AAP recommends amoxicillin/clavulanate — which is also in shortage — or one dose of ceftriaxone injected intramuscularly. Sinusitis and pneumonia can be treated with amoxicillin/clavulanate, and the AAP recommended limiting treatment to about a week for each. 

The AAP said group A streptococcus pharyngitis can be treated with penicillin VK, penicillin G benzathine x 1 delivered intramuscularly, or cephalexin. Children should not be tested if they have virus symptoms like cough and rhinorrhea. Lastly, asplenia prophylaxis can be treated with penicillin VK. 

The shortage of amoxicillin and amoxicillin/clavulanate products is expected to last months.

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