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Question

With a shortage of the antibiotic amoxicillin, what if my child needs it? Is there a replacement?

Angela Myers, MD, MPH, FAAP

Answer

This fall, we have seen an early increase in viral infections. At the same time, there is a national shortage of liquid amoxicillin—the antibiotic most often used to treat ear infections, pneumonia and sinusitis.

The bulk of the infections making kids sick have been caused by respiratory syncytial virus (RSV) and influenza. We're also seeing rhinovirus, COVID-19 and parainfluenza. These viral infections often can cause ear infections, pneumonia and sinusitis. Sometimes, bacterial infections develop during these viral illnesses as well.

As a parent, you may be wondering what to do if your child develops a bacterial infection. If liquid amoxicillin is not available, can another antibiotic be used instead?

Does my child really need antibiotics?

This is a great question to ask. In fact, there are times when "watchful waiting" is a good plan. It's not always helpful for a child to start taking antibiotic medicine right away. Often, a parent/caregiver and the pediatrician can agree to wait and see if their child gets better without the prescription antibiotic.

For example, ear infections often resolve in a few days even without antibiotics. What happens when their symptoms do not improve during that time? If the child does not have high fever (>102.2°F), severe pain or ear drainage, a "short course" of antibiotic (about 5 to 7 days) is long enough to treat the infection without causing side effects like diarrhea, belly pain and rash.

Likewise, for children with a runny nose or cough that does not improve for 10 days, watchful waiting may be used for 3 more days before prescribing antibiotics for a sinus infection, as long as the symptoms do not include fever >102.2°F. For children who do need treatment, 5 to 7 days of antibiotics may also be used.

Can we use another antibiotic instead of liquid amoxicillin?

The right antibiotic for your child depends on the type of infection and what medications are available in your area. When liquid amoxicillin is not available, the pediatrician may suggest:

  • Other forms of amoxicillin, such as chewable tablets, capsules that can be opened, or tablets that can be crushed and mixed with liquid or a bite of food like applesauce.

  • Another type of antibiotic. For example, the prescription antibiotic amoxicillin-clavulanate does a good job in treating these infections, but it causes diarrhea more frequently than amoxicillin.

Remember

When taking your ill child to the pediatrician, an antibiotic prescription is not the only option. About half of the antibiotics prescribed for respiratory infections are not needed. Ask if watchful waiting can be used for their illness and what else might help make them feel comfortable. This gives you and the doctor the opportunity to discuss all treatment options.

More information

Angela Myers, MD, MPH, FAAP

​​Dr. Myers is Director of Infectious Diseases and Medical Director of the Center for Wellbeing at Children’s Mercy Kansas City and Professor of Pediatrics at University o​f Missouri-Kansas City School of Medicine. She also is a member of the American Academy of Pediatrics Committee on Infectious Diseases.

Last Updated
11/30/2022
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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