Amoxicillin shortages fuel antibiotic resistance and severe infections in Europe
A 2026 study in Nature Communications has examined how amoxicillin shortages affect bacterial resistance and disease control across Europe. The research highlights long-term risks, including persistent resistance levels and a rise in severe infections among vulnerable groups.
The findings focus on pediatric use of the antibiotic, a key treatment for Streptococcus pneumoniae infections. The study used a dynamic model combining antibiotic consumption data, bacterial transmission patterns, and resistance evolution. Researchers found that disruptions in amoxicillin supply led to more cases of invasive pneumococcal disease (IPD), especially in children under five and older adults.
When shortages forced doctors to switch to alternative antibiotics, multidrug resistance increased. The model warned that current treatment guidelines could become ineffective by 2030 if such substitutions continue. Even after supply returned to normal, resistance rates did not quickly drop back to previous levels, leaving a lasting public health issue.
Rationing pediatric amoxicillin also backfired, as incomplete dosing sped up the spread of resistant strains. However, the study noted that higher vaccination rates against pneumococcus could help reduce bacterial transmission and soften the impact of shortages.
To tackle these challenges, the research recommended adaptive prescribing rules that reserve amoxicillin for confirmed bacterial infections. It also called for better coordination across Europe to manage antibiotic supply chains and curb resistance growth. The findings underscore the risks of amoxicillin shortages, from rising IPD cases to long-term resistance problems. Without stronger supply management and targeted prescribing, the study suggests that current treatments may lose effectiveness within the decade. Vaccination and cross-border cooperation remain critical tools in mitigating these effects.
