SSPs reactivated for clarithromycin amid surging whooping cough cases

The UK Health Security Agency (UKHSA) has confirmed 2,793 cases of whooping in the first quarter of 2024, including five infant deaths

As whooping cough cases rise sharply across the UK, the NHS has reactivated the serious shortage protocols (SSPs) for clarithromycin - a commonly prescribed antibiotic to treat this bacterial infection.

Pharmacy bodies had recently warned that community pharmacies were struggling to obtain source clarithromycin for patients.

Two SSPs, covering clarithromycin 125mg/5mL and 250mg/5mL oral suspensions, were reactivated on 22 May 2024, and extended until 21 June 2024.

These protocols state that for every 5mL of clarithromycin 125mg/5mL oral suspension, pharmacy contractors must supply 2.5mL of clarithromycin 250mg/5mL oral suspension; and for every 5mL of clarithromycin 250mg/5mL oral suspension, one clarithromycin 250mg tablet must be supplied.

The SSPs apply to cross-border prescriptions, both NHS and private.

Patients from England, Scotland, Wales or Northern Ireland who present their prescriptions for clarithromycin 125mg/5mL and 250mg/5mL oral suspensions are eligible to receive their substituted products under the terms of these SSPs.

If the pharmacist determines that the patient is unable to accommodate the switch from liquid to tablet (i.e. the patient cannot swallow tablets), they are advised to either contact the prescriber to discuss the issue (with the patient’s consent) or refer the patient back to the prescriber.

Can pharmacists supply an alternative product to patients? “If the pharmacist thinks that an alternative product, other than those listed within the SSP would be suitable for the patient, they should either contact the prescriber to discuss this (with the patient’s consent) or direct the patient back to the prescriber,” the NHS guidance said.

An SSP may be issued if the Department of Health and Social Care (DHSC) decides there is a serious shortage of a specific medicine or appliance.

When the SSPs for clarithromycin were first introduced in April 2023, they were originally intended to run for less than a month but were extended until December 2023.

The UK Health Security Agency (UKHSA) reported a total of 2,793 whooping cough cases in the first quarter of 2024 (January - March), comprising 556 cases in January, 918 in February, and 1,319 in March.

Sadly, there have been five infant deaths attributed to this lung-affecting bacterial infection this year so far.