Amoxicillin Shortage UK: Antibiotic Supply Update

Current Amoxicillin Supply Status

As of February 2026, amoxicillin supply in the UK is as follows:

Why Does Amoxicillin Keep Running Short?

Seasonal Demand Spikes

Antibiotic prescribing follows predictable seasonal patterns, peaking during winter respiratory illness season (November-March). However, manufacturers produce at a relatively constant rate year-round. This mismatch between seasonal demand and steady production creates periodic shortfalls.

The winters of 2022-23 and 2023-24 saw exceptional demand due to overlapping flu, COVID, and Strep A outbreaks. While 2025-26 has been more typical, the supply chain hasn't fully rebuilt buffer stocks.

Liquid Formulations Are Harder to Produce

Liquid antibiotics (suspensions) have shorter shelf lives than capsules and tablets — typically 14 days once reconstituted. This means:

• Manufacturers can't stockpile large inventories
• Production must closely match demand
• Wastage rates are higher due to expiry
• Fewer manufacturers produce liquid formulations compared to capsules

Global Supply Chain Pressures

Amoxicillin API is primarily manufactured in China and India. Global demand for antibiotics has increased post-pandemic, with many countries simultaneously trying to rebuild stockpiles. The UK competes on the global market for raw materials, and currency fluctuations can affect the attractiveness of supplying the UK market.

The Strep A Factor

The unusual Strep A season of winter 2022 dramatically increased demand for amoxicillin, particularly the liquid formulations used for children. This exceptional spike depleted stock that normally carried through to spring, and the supply chain has taken years to fully recover.

What Happens When Antibiotics Run Short?

Unlike medications for chronic conditions, antibiotic shortages present unique challenges:

• Time-critical treatment: Bacterial infections need prompt treatment. Delays of even a few days can lead to complications
• Limited alternatives for children: Young children can't take capsules, making liquid formulation shortages particularly problematic
• Resistance concerns: Prescribing alternative antibiotics when first-line options are unavailable can contribute to antimicrobial resistance
• Parental anxiety: Parents of sick children understandably become distressed when prescribed medication can't be obtained

What the NHS and DHSC Are Doing

• The DHSC maintains a strategic stockpile of essential antibiotics including amoxicillin
• Serious Shortage Protocols allow pharmacists to switch between amoxicillin brands and strengths
• The UK has invested in domestic antibiotic manufacturing capacity through the Medicines Manufacturing Innovation Centre
• Prescribing guidelines have been updated to reduce inappropriate antibiotic use, preserving supply for genuine need
• Real-time prescribing data allows earlier detection of demand spikes

What to Do If Your Pharmacy Is Out of Amoxicillin

For Adults

If amoxicillin capsules are unavailable:

• Ask the pharmacist about alternative suppliers — they may be able to source from a different wholesaler within 24 hours
• Try other local pharmacies including independents and supermarket pharmacies
• Ask your GP about alternative antibiotics: phenoxymethylpenicillin, clarithromycin, or doxycycline may be appropriate depending on your infection
• For dental infections, metronidazole may be prescribed alongside or instead of amoxicillin

For Children

If liquid amoxicillin is unavailable:

• Pharmacists can make an extemporaneous preparation — crushing capsules and mixing with a suitable liquid vehicle. This is a legitimate pharmacy practice
• For older children who can swallow capsules, the GP can prescribe amoxicillin capsules instead
• Phenoxymethylpenicillin liquid is often available as an alternative for many childhood infections
• Hospital pharmacies may have stock — your GP can advise if this route is appropriate

Preventing Future Antibiotic Shortages

Long-term solutions being pursued include:

• Onshoring production: The UK government is investing in domestic pharmaceutical manufacturing to reduce dependence on overseas API suppliers
• Better demand forecasting: Using AI and prescribing data to predict seasonal demand more accurately
• Strategic stockpiling: Maintaining larger buffer stocks of essential antibiotics, particularly liquid formulations
• Antimicrobial stewardship: Reducing unnecessary prescribing to ease demand pressure while preserving antibiotic effectiveness

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