Strep A: new UK protocols issued as pharmacists cope with penicillin supply

Read More

Five new serious shortage protocols (SSPs) have been issued to pharmacists in an attempt to offset penicillin supply issues caused by the rising number of strep A infections across the UK.

The government introduced SSPs for three penicillin medicines earlier this week and has now upped that total to give pharmacists the flexibility to supply an alternative antibiotic or formulation of penicillin.

The move comes amid an increasing demand for penicillin, which is commonly used to treat strep A infections such as scarlet fever and impetigo.

The number of scarlet fever cases are three times the usual and some pharmacists are experiencing temporary and localised supply issues.

Prof Susan Hopkins, the chief medical adviser at the UK Health Security Agency (UKHSA), told BBC Radio 4’s Today programme: “The latest with scarlet fever and strep A infections are that we’ve seen just over 7,500 notifications of scarlet fever, and that’s probably an underestimate.

“We have a lot of reports in the past few days so we expect it to be even higher. That’s about three times higher than the same time in a normal season. The last bad season we had in 2017-18.”

It is understood that health officials do not believe the number of scarlet fever infections has yet peaked, suggesting more deaths are likely.

This upward trend can also be seen with cases of invasive group A strep (GAS), the most severe and unusual form of infection.

Hopkins said these cases were “more than halfway through what we’d normally see in an average season”, with 111 cases recorded in children aged one to four and 74 cases in children aged five to nine.

While the latest figures show that at least 19 children have now died across the UK from invasive strep A disease, she assured that the vast majority of children affected have a mild illness.

An “open mind” is being kept as to the reasons behind this spike.

Stressing that “we’re not convinced of anything yet”, she said: “I think we’re seeing it this season much, much earlier.

“We’ve got a lot of children who have not had this infection over the last three years, so there’s more susceptible children who have not started to develop their immunity to this infection, which we get repeated times over the course of our lives.

“We’re always looking for other reasons. Has the bacteria changed? Is there any other changes in that might have occurred that are causing this?”

All children aged two and three are eligible for a flu nasal spray vaccine to reduce the risk of infection, though take-up is currently less than 40% for both ages – well under the level reached at this point in previous winters.

Only 37.4% of two-year-olds and 39.5% of three-year-olds have received the vaccine so far, according to the latest data.

Hopkins said there were lower group A strep infections in areas where children had been offered the vaccine compared with those where the rollout had not yet started.