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Alwayssunnyinarizona t1_izja6t1 wrote

One thing I think you're misunderstanding:

>In the absence of asthma or secondary infection

Upper/lower respiratory infections are rarely single factor. You've got a virus - influenza, parainfluenza, coronavirus, whatever, and then you've got the secondary bacterial invaders - Staph, Strep, Haemophilus, etc etc etc. Those may linger for a while because of the damage the virus has already done to the bronchial/upper airway lining, as well as to the immune system itself in some cases. Some of that damage is fixed with a temporary bandaid much like scar tissue, and can take a week or two to heal completely.

Here's a review on secondary bacterial infections in cases of viral pneumonia:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419580/

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RogueColin t1_izjdtdj wrote

Thanks for this. I work in a hospital compounding IV medications and I wasn't really understanding why I was making so many antibiotics for RSV infections, but this makes sense.

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[deleted] OP t1_izjes2d wrote

[removed]

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contrary-contrarian t1_izjmie1 wrote

Bingo. That's why there is a shortage of amoxicillin right now. So many RSV and other respiratory viruses causing secondary infections.

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Scarlet- t1_izjoz6h wrote

I checked my supplier two days ago and the only available strength for amoxicillin suspension was 400 mg/5 ml with a quantity of 6 to supply any contracted pharmacy in Nevada and possibly Arizona. I had to order 3. 🤦‍♂️

I hope supply meets demand soon. Everything is being affected: adderall, antibiotics, antivirals, diabetic auto injectors.

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EmilyU1F984 t1_izkkfip wrote

You get liquid? Only ones we can safely get is Tablets in my part of Germany. Liquid formulations are on Backorder..

Not that I’d personally mind compounding those Tablets into a suspension ifneed be… but being a retail pharmacy… those prescriptions are virtually never for a confirmed bacterial infection, but rather ‚if things get worse‘

Like wtf if things get worse, you hand the prescription to the parents and have it picked up/delivered by the pharmacy. Don‘t have patients keep out of stock antibiotics at home -.-

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Scarlet- t1_izktgwh wrote

Yes, but the liquid stock comes and goes. For the most part they have been on back order for a few weeks.

Is compounding antibiotics from tablet to liquid a common thing in retail pharmacies in Germany?

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ChaoCobo t1_izni6y1 wrote

Wait why are adderall and daibetic auto injectors running low?

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Scarlet- t1_iznj0ai wrote

Suppliers are having trouble meeting demands.

I don’t know the exact reason for adderall, but I noticed it happened after the mislabeling of adderall 15mg generic. 20mg was produced with a 15mg label on it. That was pulled from market and then began a slow cascade of people switching to different manufacturers/strengths resulting in a shortage. Again, this is from my observation. The FDA’s website has more on this.

For the diabetic auto injectors, ozempic being used for its non-FDA indication of weight loss resulted in a shortage resulting in a cascade of events like patients switching to different strengths or trulicity, mounjaro, etc. Now all the manufacturers are having trouble keeping up with demand.

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Indemnity4 t1_izurvp6 wrote

Adderall is in short supply because two factors:

  • a main manufacturer Teva Pharmaceuticals shutdown during Covid due to worker shortages. They are still having disruptions to manufacturing.

  • prescriptions are up, way up. Highest they have ever been. Big social media campaign during the locksdowns and lots of attention on mental health diagnosis. Adderall is the first medicine most people with ADHD will attempt.

Diabetes auto injectors is because it now has two uses and one of those makes the company more money. (Semaglutide, sold as the brand name Ozempic and Wegovy) is only manufactured by one company using a very delicate and expensive process. The company split the output from the factory into two products: Ozempic for diabetes type 2 and Wegovy for non-presciption weight loss. Same product, but two different uses and the company presumably makes a lot more money as a lifestyle drug. It is immensely hugely crazy mammoth popular for off-label prescriptions for weight loss.

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Scarlet- t1_j00omc3 wrote

>Teva Pharmaceuticals shutdown

That explains a lot! Thank you.

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Steve0512 t1_izka06p wrote

I went to the clinic after three weeks of coughing and the doctor prescribed me a dosepak of Steroids. In the end it worked.

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kramsy t1_izm51vs wrote

We’ve moved on from Amoxicillin and are writing for Omnicef now…no one could get Amoxicillin.

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Pharmie2013 t1_izmckvx wrote

Oddly enough I can’t find cefdinir but have been lucky to stay ahead of my amox supply.

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IGotNoStringsOnMe t1_izjqr0x wrote

Would some of the coughing be due to the scar tissue healing like when scabs itch like mad? Or is it all down to the secondary invaders?

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Alwayssunnyinarizona t1_izk8og8 wrote

A bit of both :) your respiratory tract is lined with cilliated cells - they have little finger-like projections that help move mucus and debris from your lungs to your mouth. When you wake up in the morning with crap in your throat - that's why. Some respiratory viruses and bacteria can damage those cells, and affect how well they move stuff up, so the lining is more like flattered cells for a few days. While that continues to heal, bacteria have a better chance of growing there, but eventually either your immune system clears it and the cells heal, or it gets worse and you die ;)

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yayreddit02 t1_izmzmch wrote

That last part made me laugh (even though im reading this thread because my covid cough hasn’t gone away after 2 months)

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tehbored t1_izm20wo wrote

Is this true even for an ordinary cold? Because I often have residual mucus for a week or so after the main symptoms go away.

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Alwayssunnyinarizona t1_izm403h wrote

There are always bacterial agents waiting to take advantage of weakened defenses, but severity varies quite a bit for all sorts of reason. Some lagging symptoms may also be things like the body's healing response.

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