Pediatric emergencies are at the top of the wave of . Childhood respiratory viruses overlap for the first time with COVID-19 and complicate the already precarious situation in Spanish hospitals.
To this is added, in addition, the shortage of amoxicillin, as has been warned by the Spanish Agency for Medicines and Health Products (AEMPS).
Laboratories that “have a greater market share of these medicines” have experienced delays in the introduction of new batches, “which has caused the current supply problem” in almost all pharmacies in our country.
But, is this setback caused by the avalanche of bronchiolitis cases?
we talk about a Respiratory infection Produced by a virus that causes inflammation of the bronchi and bronchioles, which are the smallest tubes through which air circulates within the lung.
-
This is the first infection that occurs in the child’s respiratory tract, which always occurs when the child is under 2 years of age and is only suffered once in a lifetime.
RSV is the main cause of bronchiolitis among infants, in up to 75% of cases. However, there are other viruses that also cause this pathology. They are the different members of the rhinovirus group:
-
Human bocavirus.
-
Human metapneumovirus.
-
Influenza viruses.
-
Parainfluenza viruses.
COVID has revolutionized viruses: bronchiolitis ahead of time
And, although the explosion of cases has arrived earlier than expected, he explains to this portal the Dr. Veronica Sanz“every year we have an outbreak of bronchiolitis due to respiratory syncytial virus around this time of the year, but the subjective feeling is that there are more cases”.
The explanation of the incidence curve at discharge, highlights the coordinator of the pediatric pulmonology area of the (SEPAR):
-
“It is because in the last two seasons RSV has barely circulated and there are children who are susceptible to infection because they have not been exposed to the virus.”
It is a viral infection that manifests with difficulty breathing and, on many occasions, with “whistles” on the chest. The first symptoms with which bronchiolitis begins are those of a common cold: cough and nasal mucus.
Fortunately, it is a mild disease, although there are cases in which bronchiolitis can be complicated by breathing problems and hospitalization may be necessary.
-
“Most children will experience bronchiolitis as if it were a slightly stronger cold, although in 2% of cases it will become complicated and hospital admission will be required due to the need for oxygen.”
No, amoxicillin is not used to treat bronchiolitis
Since last November 18, there have been problems “with the supply of pediatric oral suspensions of amoxicillin“, as reported by the .
The shortage of this medicine, of 250 milligrams in oral suspension, that is, it needs to be dissolved in water, has coincided with the wave of bronchiolitis in Spain, which is collapsing hospital emergencies. However, it is just a coincidence.
Bronchiolitis has no treatment
The lack of amoxicillin, which has also occurred in other neighboring countries, such as Portugal and France, has set off alarm bells among parents.
Many of them believe that amoxicillin is the key to treating respiratory infections such as bronchiolitis and preventing them from leading to more serious cases that require hospitalization. But nothing could be further from the truth, as Dr. Sanz explained to ‘Guías de Salud’.
-
“For bronchiolitis, unfortunately, there is no treatment that can accelerate its healing. And amoxicillin, in no case. It is not the indicated medicine to treat this infection, because it is an antibiotic, which is not used to treat viral processes ”.
Moreover, minors who need hospital admission due to complications derived from bronchiolitis do not need this medication, which is so scarce in Spanish pharmacies.
-
“Only in a small percentage of bronchiolitis can it be superinfected, and only in these cases is the administration of antibiotics necessary.”
For the peace of mind of the parents, in most cases the child improves in the first two weeks (although it can last up to three weeks) with care at home and with a treatment to alleviate the symptoms of bronchiolitis, such as fever, cough and nasal congestion.
As for the recommendations: wash the nose with physiological saline in case there is excess mucus, put him in a semi-upright position, let the baby feed more frequently and less.
So why is there a shortage of amoxicillin?
The laboratories “are prioritizing the manufacture of amoxicillin in oral suspension”, and it is expected that throughout this week “the supply will return to normal”.
However, as an exceptional measure, from the AEMPS, it is recommended to administer drugs that are presented in 500 mg scored tablets “half a tablet” that “can be dissolved or disintegrated in water”.
Amoxicillin is an antibiotic to treat infections as frequent as tonsillitis, acute otitis media, sinusitis, pneumonia, urinary, skin or dental infections.
A measure to guarantee the treatment of patients, but not to cure bronchiolitis.
As Dr. Verónica Sanz points out, this medicine “is widely used to treat otitis derived from respiratory infections and pneumonia, and in some cases even for sore throats.”
Although the shortage of amoxicillin does not respond to the increase in this type of disease, but to the delay, by the two laboratories that have a greater market share, in the production process.