The situation repeated a year ago
Popular imported broad-spectrum antibiotics based on amoxicillin and clavulanic acid — amoxiclav, augmentin, suprax, etc. — have again almost completely disappeared from pharmacies. We are dealing with a similar situation already faced about a year ago, and then the shortage affected many countries of the world. Now almost all pharmacy chains in the country report the absence of these antibiotics. MK asked experts about the reason for the shortage.
Foreign-made drugs based on amoxicillin and clavulanic acid are indeed in stock everywhere. We were informed about this in several pharmacies where we contacted. Only one network had one of the antibiotics in stock, but only in some warehouses, on remnants. “The distributors no longer have these antibiotics at all,” they said. Another chain pharmacy said that in September these drugs appeared in small quantities for a short time: “Then they disappeared again from the suppliers. For example, the antibiotic vilprafen was out of stock, it appeared in September, but literally for a week, and again the suppliers do not have it.”
“Imported antibiotics with clavulanic acid have disappeared today,” says pharmacist Victoria Presnyakova, head of the Alliance of Pharmaceutical Associations. — These product items are not even in the suppliers’ price lists. Some positions appear periodically, but then disappear again. But today pharmacies have domestic antibiotics with this composition.”
As Presnyakova reminds, we are talking about broad-spectrum antibiotics, which allows the doctor to empirically prescribe these drugs, determining the high probability of success of therapy: “Antibacterial drugs are prescribed only in the presence of a proven bacterial infection. Most often — with pathologies of the ENT organs, respiratory tract, and infections of the genitourinary system. If we talk about antibiotics based on amoxicillin and clavulanic acid, then this group of drugs has many trade names. But for the doctor, only the dosage and active ingredient of the antibiotic matter. That is, a specialist in the absence of one medicine, if necessary, will simply replace it with another.”
No one knows the exact reasons for the disappearance of popular antibiotics from the market. None of the foreign companies have yet announced their withdrawal from the Russian market. It is unlikely that the situation is related to supply logistics: over the past year this problem has been resolved, at the very least. As Nikolai Bespalov, development director of the analytical company RNC Pharma, told MK, most likely the reason for the current shortage of antibiotics of the mentioned group on the market is, as last time, a problem with the production of clavulanic acid: “A year ago, this problem became relevant for the whole world . The fact is that the main producer of clavulanic acid in the world is China, and when technological disruptions in production began, shortages were felt in many countries around the world, including Russia. It is logical to assume that something similar happened this time too. Although I have not heard any signals from other countries about shortages of these antibiotics. It is possible that countries drew conclusions based on the past situation and established domestic production of clavulanic acid.”
And yet, the absence of the mentioned antibiotics in pharmacies has already become a reason for… bringing them to administrative responsibility. According to licensing requirements, a pharmacy must have a minimum range of drugs, otherwise it may receive a fine. As market experts told MK, the country has two officially registered drugs with the international nonproprietary name (INN) amoxicillin in the form of “powder for the preparation of an oral suspension,” which must be available in accordance with the List of Minimum Assortment for Pharmacies. These are drugs of Russian and Austrian production. And today they are not on the market. Also, other drugs periodically enter the regional shortage. For example, from the beginning of the year, distributors did not have drugs with the INN loratadine in the dosage form “syrup”; periodically there was no place to order bisacodyl tablets from pharmacies.
Recently, the prosecutor's office opened a case of administrative violation against one pharmacy in the Stavropol Territory due to the lack of bisacodyl in tablets. “And in a private conversation they said: don’t you know how everyone else does it? Put one package in a box and don’t sell it,” says the pharmacy director. And such situations happen regularly. “The mechanisms for creating the list and promptly making changes to it, which should first of all guarantee adequate drug supply, are not working today,” representatives of the SRO “Pharmacy Guild” wrote in an official letter to the government. — In the post-pandemic and sanctions periods, sometimes there is a persistent shortage of any item from the minimum assortment at wholesale organizations, and the pharmacy is deprived of the opportunity to replenish stocks of the minimum assortment, since the pharmacy cannot purchase drugs from anyone else. The distributor is not responsible for the absence of drugs from the minimum range.”
No one can predict whether imported antibiotics containing amoxicillin will appear in the country. Of course, the situation is not catastrophic, but many doctors criticize their Russian analogues: patients tolerate them worse. “We can only wait,” experts say.