With COVID-19 still hanging on, the flu season beginning early and respiratory syncytial virus, or RSV, adding to the problem, an ongoing nationwide shortage of medicines used to treat common childhood illnesses such as the flu, ear infections and sore throats is the last thing any pharmacist, physician or parent wanted to see.

Yet that nightmare scenario is the current reality throughout Oklahoma and across the nation.

Children are being affected disproportionately because the shortages primarily are in liquid versions of drugs such as amoxicillin and Tamiflu, which typically are prescribed for children who are too young to take tablets or capsules, said pharmacist Jim Pritchard, a co-owner of Spoon Drug, 540 Plaza Court in Sand Springs.

“Amoxicillin tablets and capsules are in plentiful supply,” he said, but the type of amoxicillin that is made into an oral suspension can’t be found.

Pritchard is puzzled as to why the shortages have occurred.

“No one has answered that for me. I don’t have a clue as to why” such commonly prescribed drugs are not available, he said.

“You would think that with winter coming in and flu season and colds and kids back in school, there should have been plenty on hand back in September and October to last through March,” he said.

Infectious disease experts say the problem isn’t so much a supply issue as a demand issue, and they point out that it’s not just the “big three” viruses — COVID, flu and RSV — that are problematic. Other respiratory illnesses, such as rhinoviruses and adenoviruses, also are making the rounds, and they started circulating earlier than usual.

“The viruses are having a convention,” Dr. William Schaffner, professor of infectious diseases and preventive medicine at Vanderbilt University in Nashville, told The New York Times.

Although viruses aren’t helped by antibiotics, which are used to treat bacterial infections, in many cases infections that develop subsequently to the viral infection require antibiotics.

In the meantime, pharmacists are finding themselves on the front lines in the battle to keep common childhood illnesses from overwhelming the health care system, a system that already has seen a surge in pediatric hospitalizations.

For a brief time, Spoon Drug was seemingly the only pharmacy in Sand Springs with a supply of amoxicillin.

“We have multiple suppliers, and I think we were just at the top of the list, and when they would get some in, they would call us,” said pharmacist Jim Spoon, a co-owner of the drugstore that has two locations in Sand Springs.

“At one point we were still able to receive some when no one else was getting it because we had found locations where there was some stock,” Pritchard said. “Those are all dried up now.”

But that doesn’t mean the only option is to go without medication, he added.

“Sometimes we can adjust the dosage to get the correct milligram to the child,” Pritchard said. “As long as we get the correct milligrams per dose — that’s the critical thing. And we double- and triple-check all of that, especially with the little kids.

“If it’s totally unavailable, we have to use alternate drugs,” he said, but “we still have antibiotics that will work. It may not be the antibiotic of choice for the doctor, but there are still options out there that are effective.”

Pritchard said he and his colleagues “stay in close contact with all of our doctors, especially the doctors in our immediate area. They work with us very well.”

The federal Food and Drug Administration said health-care providers and pharmacists alike should be prepared for the shortages to last for some time.

“I don’t think the need for the product is going to lessen any for a while,” Spoon agreed. “I think we’re just keeping as much on hand as we can. We’re just going to continue to order it to try to stay ahead of it.”

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