About the antibiotics shortage 2022-2023

We are aware of current shortages of some antibiotics in Australia, including:

• amoxicillin (these products are returning to supply and most brands are now available)
• amoxicillin and clavulanic acid combination medicines
• cefaclor
• cefalexin (all capsules are now available, oral syrups and suspensions remain in short supply)
• phenoxymethylpenicillin
• sulfamethoxazole and trimethoprim combination medicines
• trimethoprim.

We recognise that antibiotics are important in treating patients and are facilitating supply of alternative medicines as a priority.

Manufacturing issues or an unexpected increase in demand have caused most of the shortages.

We publish up-to-date information on these shortages, including predicted return to supply dates, in our medicine shortage reports database. You can sort the database by clicking on 'Therapeutic class' and scrolling down to 'General anti-infectives for systemic use' to see the list of antibiotics currently in shortage.

Why have these shortages occurred?

Manufacturing issues or an unexpected increase in demand led to most of these shortages.

Disruptions to the supply of medicines in Australia can occur for many reasons, ranging from

• shortages of raw materials
• batches of the medicine not meeting Australian specifications
• logistical delays including potential impacts of global events 

These disruptions to supply happen despite pharmaceutical companies doing their best to maintain supply through demand forecasting and stock control.

The Medicine shortage reports database lists the reason for the shortage that the pharmaceutical company has provided to the TGA.

When will the shortages be resolved?

We expect many of the shortages to resolve in the next few months, and many have already resolved. However, there are ongoing global constraints for some products which will see their shortages extend until the end of 2023.

The Medicine shortage reports database provides the most up to date information on medicine shortages. Sponsors can update the shortage end dates at any time and we publish any changes on the database.

What are you doing about the shortages?

To minimise the impact of the current antibiotic shortages, we:

• Published an Antibiotic Shortage webpage containing multiple alerts and advice for prescribers. Advice includes advising prescribers to consider alternative brands or strengths of an antibiotic which is in shortage, if available. Prescribers may also consider prescribing an alternative antibiotic with a similar spectrum of availability.
• Approved multiple overseas-registered alternative antibiotics for temporary supply under section 19A of the Therapeutic Goods Act 1989, some of which are listed on the PBS. You can search our Section 19A approvals database to check if there is an approved alternative medicine.
• Made Serious Scarcity Substitution Instruments (SSSIs) for oral amoxicillin, cefalexin, and phenoxymethylpenicillin medicines. The SSSIs allow pharmacists to dispense another dosage form or strength of the same antibiotic to a patient, without prior approval from the prescriber. They can only be used if the prescribed antibiotic is unavailable and the conditions of the SSSI have been met. As amoxicillin products are returning to supply, we have allowed that SSSI to lapse.
• Are working with wholesalers to facilitate equitable distribution and prevent stockpiling.

We continue to monitor medicine shortages, review the actions we have taken, and work with sponsors to facilitate adequate supply for patients in Australia.

What if I can’t get my antibiotic?

Importantly, many antibiotics have alternatives available. Your pharmacist may be able to give you a different brand, or your doctor can prescribe a different strength or medicine with similar spectrum of activity. We have also approved overseas-registered alternatives for many antibiotics. Your pharmacist can ask about ordering these overseas-registered alternatives for you by contacting the approval holder listed in the section 19A approvals database.

If infection isn’t treated, it can lead to serious illness and death. If you can’t get your antibiotic prescription filled, talk to your doctor, pharmacist Aboriginal and Torres Strait Islander health worker or practitioner to make sure you get good medicine.

To assist with the shortage of oral amoxicillin, cefaclor, cefalexin, and phenoxymethylpenicillin (Penicillin V) products, the TGA has made three Serious Scarcity Substitution Instruments (SSSIs). Each SSSI allows a pharmacist to dispense a substitute product containing the same active ingredient when the prescribed product is unavailable. A pharmacist can use a SSSI without talking to the prescriber, under certain conditions.

More information about these SSSIs is available in our table of current SSSIs or

• About the shortage of oral cefalexin
• About the shortage of phenoxymethylpenicillin
• About the shortage of cefaclor

We continue to monitor antibiotic medicines in shortage and are actively seeking and prioritising applications for overseas alternatives to assist with supply.

More information about medicine shortages can be found on our shortages page.

What resources are available to help me?

The Australian Commission of Safety and Quality in Healthcare (ACSQHC) have produced general guidance for consumers and health professionals. The guidance outlines what to do when antibiotic medicines are in shortage:

• Consumer guidance on antimicrobial shortages
• Clinical guidance on antimicrobial shortages for health professionals

Therapeutic Guidelines have published a resource that will help prescribers choose an alternative antibiotic if their preferred one is in shortage.

The National Centre for Antimicrobial Stewardship have fact sheets with clinical advice for health professionals about specific antibiotic shortages.

For evidenced-based advice on modifying oral dosage forms of medicines, health professionals can use Don’t Rush to Crush (4th Edition). This contains advice that clinicians can use for people with swallowing difficulties and enteral feeding tubes.