Amid a shortage of the antibiotic amoxicillin, the AAP has issued guidance on alternatives to the oral powder formulation for suspension in its Red Book Online. The shortage, which is expected to last several months, is being fueled by increased demand as many US children are ill with respiratory diseases such as the flu, COVID-19, and respiratory syncytial virus (RSV), according to amoxicillin manufacturers reporting shortages to the FDA. Though antibiotics aren’t indicated for these viral illnesses, clinicians may prescribe them presumptively. The AAP first urges clinicians not to prescribe antibiotics to patients with viral illnesses, because overprescribing can lead to antibiotic resistance. To use tablets in pediatric patients, clinicians can split or crush them, and they can open capsules and split chewable formulations and mix them with liquid or a semisolid such as applesauce to be given by mouth or tube. If amoxicillin isn’t available or can’t be used in a patient owing to hypersensitivity, the guidance said, pediatricians can treat ear infections with amoxicillin/clavulanate or intramuscular ceftriaxone. Learn more on cidrap.edu.