26 June 2024

Two more liquid antibiotics join the shortage list

Clinical Respiratory TGA

NSW clinicians have been asked to ‘carefully consider’ scripts for azithromycin and clarithromycin.


Healthcare professionals in New South Wales have been asked to cut back on prescriptions for the liquid formulations of two more oral antibiotics in short supply. 

NSW Health put out a communique last week requesting that they “carefully consider” the need for antibiotic treatment, amid possible shortages of azithromycin and clarithromycin. 

These antibiotics join the ever-growing list of common antibiotics that have been in national shortage over recent years, including amoxicillin and cephalexin. 

While shortages have affected the entire country, the recent rise in Mycoplasma pneumoniae and Bordetella pertussis (whooping cough) infections in NSW may be adding to supply concerns. 

The communique reminded healthcare professionals about the lack of effectiveness of antibiotics in mild-moderate cases of M. pneumoniae and later in the progression of the infections. 

“Antibiotics have limited efficacy in most mild-moderate cases of confirmed or suspected Mycoplasma pneumoniae infection,” it read. 

“As per the Paediatric Improvement Collaborative guidelines, antibiotics may be prescribed if a child has clinical features suggesting a need for referral to hospital e.g. signs of LRTI with respiratory distress or hypoxaemia. 

“In patients of any age, antibiotic treatment is recommended if the diagnosis of pertussis is made within three weeks of cough or other symptom onset.  

“Three weeks after symptoms begin, patients are rarely infectious and antibiotic therapy is not indicated.” 

Healthcare professionals were encouraged to contact their local pharmacy for availability prior to prescribing antibiotics. 

According to the TGA, shortages of liquid azithromycin and clarithromycin are expected to last until late November and the end of August respectively

Azithromycin 200 mg/5 mL powder for oral suspension, an international alternative liquid azithromycin, has been made available through Section 19A of the Therapeutic Goods Act 1989 to combat the shortage. 

Viatris Pty Ltd is working to expedite the next shipment of liquid clarithromycin to resolve the supply issue. 

The full NSW Health update can be found here, including recommended first- and second-line treatments for Mycoplasma pneumoniae and whooping cough.