Changes and extension to Serious Shortage Protocols for phenoxymethylpenicillin products.

The eight Serious Shortage Protocols (SSPs) for phenoxymethylpenicillin products have been extended. The revised date is now 28 February 2023.

• Phenoxymethylpenicillin 125mg/5ml oral solution sugar free (SSP040)
• Phenoxymethylpenicillin 250mg/5ml oral solution sugar free (SSP041)
• Phenoxymethylpenicillin 250mg/5ml oral solution (SSP042)
• Phenoxymethylpenicillin 125mg/5ml oral solution (SSP043)
• Phenoxymethylpenicillin 125mg/5ml oral solution sugar free (SSP044)
• Phenoxymethylpenicillin 250mg/5ml oral solution (SSP045)
• Phenoxymethylpenicillin 250mg/5ml oral solution sugar free (SSP046)
• Phenoxymethylpenicillin 250mg tablets (SSP047)

Amendments have been made to the five Serious Shortage Protocols (SSPs) for phenoxymethylpenicillin products which enables therapeutic substitution (SSP043, SSP044, SSP045, SSP046 and SSP047). Azithromycin and Clarithromycin are NO longer included within the priority list of antibiotic alternatives for less than 10 days treatment. The preference order is now:

1. Amoxicillin
2. Flucloxacillin
3. Cefalexin
4. Co-amoxiclav 

Details of the dosages and formulations are available from the original SSP documentation. The RPS published an illustration that summarised the substitution options provided by the SSPs, this has been updated to reflect these changes. 

Pharmacies in Scotland should await issuance of a PCA from the Chief Pharmaceutical Officer before enacting the guidance in the SSPs.