Antibiotic shortage sparks fears for Indigenous kids amid disease outbreak in remote community

Doctors dealing with outbreak of an infectious kidney disease in Far North Queensland are grappling with a shortage of the preferred medical treatment.

Six children in the Aboriginal community of Yarrabah, south of Cairns, have contracted post-streptococcal glomerulonephritis, or APSGN, which is a rare disease that can develop after infections with streptococcus bacteria.

Gurriny Yealamucka Health Service director Jason King said the symptoms of APSGN could be “subtle”, but it was a serious infectious condition that could “rapidly spread” and cause long-term health effects.

“Due to a number of factors, it can compound and create a population that has earlier and worse rates of chronic kidney disease,” he said.

The outbreak comes as healthcare practitioners nationwide experience a shortfall in supply of an antibiotic sold under the name Bicillin L-A, which Dr King said was the preferred treatment for APSGN, rheumatic heart disease and syphilis.

Those diseases disproportionately affect Aboriginal communities such as Yarrabah.

“We’re really faced with difficult circumstances where we’re forced to use second-line alternatives which are often more difficult to administer across a time frame,” Dr King said.

Global shortage

National Pharmacy Guild Queensland branch president Chris Owen said Australia was at “the mercy of worldwide trends” when it came to ensuring the supply of medicines like Bicillin L-A.

“Over the past six months antibiotics have been a particularly low source priority,” he said.

Australian policy requires a four to six-month stockpile of certain medications listed on the Pharmaceutical Benefits Scheme and orders are usually submitted six to 12 months in advance.

“We’re trying to estimate demand and sometimes we get that wrong,” Mr Owen said.

“Sometimes there’s a spike in these cases that wasn’t foreseen and there’s not enough supply in the country to go around.”

In addition to the APGNS outbreak, rates of syphilis – also treated with Bicillin L-A – have risen in far north Queensland and the Torres Strait Islands in the past three years.

Remote communities are over-represented in the national data, which this year showed the highest annual increase in syphilis rates since the disease became notifiable in 2004.

In a statement, the Therapeutic Goods Administration said it acknowledged “the importance of reliable antibiotic supply”, but had been advised by manufacturer Pfizer that a worldwide shortage of higher and lower-strength varieties of the medicine would continue until November next year.

A spokesperson said the TGA had issued a notice allowing wholesalers to “to constrain supply to facilitate equitable distribution” and that the issue was being worked on with the relevant federal, state and territory government bodies.

“We recognise the critical importance of Bicillin in Aboriginal communities, especially in light of the recent outbreak of APSGN in Yarrabah in Far North Queensland,” the spokesperson said.