Pharmacies around Male' have run out of three commonly used injectible antibiotics! Ampiclox (a combination of Ampicillin and Cloxacillin) has not been available for a few days and today caretakers are struggling to find both Augmentin and Cefuroxime for their loved ones at pharmacies in Male'.

This is not the first time this has happened. This time around, however, the number of people affected could well be more than on previous occasions. At least that is the impression I got at work today. STO, the largest importer and distributor of pharmaceutical products in Maldives, is the local reseller of all three products. What is more alarming is that there is fear that a fourth drug, Ceftazidime, also an antibiotic, could be declared out of stock in the coming days.

The situation has caused several kids (I am not personally aware of adults cases) to have their antibiotic therapies changed in the past few days, some who were apparently responding well to the empirical treatment. I have had a difficult time today, explaining to parents of a few of those kids affected as to why the treatment had to be changed.

We as clinicians are, at the very least, partly responsible for this problem. This judgement of mine may be challenged by some of my colleagues, but I strongly believe that these and other antibiotics have been irrationaly prescribed, more so during the past few months. I am sure, if willing, STO could release figures to show that these drugs were sold in larger numbers in the past few months than usual. It is my personal observation, as a practicing clinician, that they were indeed prescribed more frequently than usual these past few months. This is perhaps a result of the recent epidemic of viral ARI in the capital. Needless to say, viral ARI does not need to be treated with antibiotics, unless complicated by a secondary bacterial infection or strong suspicion of the same happening is raised.

I was told today, by a pharmacist at STO, that they do not have either drug (Augmentin or Cefuroxime) in stock and that he could not predict when it would be available again. This is tragic. It does not mean the end of the world, but still, it is an unacceptable situation, to say the least.

I would like to urge all those responsible to ensure that this does not recur anytime in the future. This certainly does compromise the medical treatment offered to our patients and as such every effort should be made to ensure that we do not face the same situation again, ever.

Lets hope that someone with an administrative authority, who could ensure that remedial action is taken promptly reads this post.