The global crisis of antibiotic shortages is worsening treatment outcomes. In 2023, one in six bacterial infections worldwide resisted antibiotic treatments, according to World Health Organization a specialized agency of the United Nations responsible for international public health data. Now, shortages of these life-saving drugs are making the situation even worse. Doctors can't treat infections when the right drugs aren't available. Patients face longer hospital stays, higher risks of complications, and sometimes death. This isn't just a problem in one country; it's a global crisis affecting everyone.
Why antibiotics are running out
Manufacturing challenges, economic pressures, and geopolitical events like Brexit are driving antibiotic shortages. According to the European Court of Auditors a European Union body that audits the EU budget Special Report 19/2025, the UK saw drug shortages jump from 648 in 2020 to 1,634 in 2023. Why? Regulatory compliance costs have increased by 34% over the past decade, making it hard for manufacturers to invest. The ECA report also points out that "rigorous manufacturing facilities are required to produce sterile injectables. Yet, because of the low worldwide market price, manufacturers have little incentive to make the required investments." This is especially true for generic antibiotics, which account for 85% of antibiotic use but have seen prices drop by 27% since 2015.
Specific antibiotics in critical shortage
Penicillin G benzathine a long-acting antibiotic used to treat syphilis and strep infections has been in short supply since 2015. This drug treats syphilis and strep infections. Without it, doctors have to use alternatives that may not work as well. Amoxicillin a common antibiotic for bacterial infections like ear infections and pneumonia shortages are also severe. The European Medicines Agency the EU agency responsible for medicines evaluation announced a shortage of amoxicillin and its combination with clavulanate in January 2023. This led to a 55% reduction in amoxicillin use across 22 databases and a 69% reduction in amoxicillin with clavulanate use across 16 databases. The U.S. Food and Drug Administration the U.S. agency regulating food and drugs documented 147 active antibiotic shortages as of December 2024.
Regional impacts of antibiotic shortages
Global data shows stark differences in how shortages affect different regions. The World Health Organization Global Antibiotic Resistance Surveillance Report 2025 found that in the South-East Asian and Eastern Mediterranean regions, one in three infections is resistant to antibiotics. In Africa, the rate is one in five. The European Economic Area reports 28 countries facing antibiotic shortages, with 14 considering them "critical." Meanwhile, the U.S. has the highest number of active shortages. This table shows the regional breakdown:
| Region | Resistance Rate | Shortage Status |
|---|---|---|
| South-East Asia | 1 in 3 infections resistant | Critical shortages in many countries |
| Eastern Mediterranean | 1 in 3 infections resistant | Critical shortages |
| Africa | 1 in 5 infections resistant | Severe shortages |
| United States | Varies by drug | 147 active shortages (FDA Dec 2024) |
| European Economic Area | Varies | 28 countries affected; 14 critical |
Real-world consequences for patients and doctors
Healthcare workers are feeling the pinch. Dr. Sarah Chen, an infectious disease specialist in California, shared on the American Public Health Association forum: "I've had to use Colistin a last-resort antibiotic with severe side effects, a toxic last-resort antibiotic, for a routine urinary tract infection because first-line treatments were unavailable." In the UK, a physician on Reddit mentioned rationing amoxicillin post-Brexit: "We have to use broader spectrum antibiotics, which increases resistance risk." In Kenya, a nurse reported sending patients home without treatment when penicillin wasn't available. A survey by CIDRAP Center for Infectious Disease Research and Policy found 78% of U.S. hospital pharmacists modified treatment protocols due to shortages, with 62% seeing increased patient complications.
Solutions and current efforts
Hospitals are developing strategies to cope. Johns Hopkins Hospital a leading medical research and teaching institution reduced unnecessary broad-spectrum antibiotic use by 37% during shortages by implementing Antimicrobial stewardship programs structured programs to optimize antibiotic use. These programs monitor usage and identify shortages early. California established a regional antibiotic sharing network in 2024, reducing critical shortage impacts by 43% across participating hospitals. The World Health Organization announced a five-point action plan in October 2025, including a Global Antibiotic Supply Security Initiative with $500 million in funding. The U.S. FDA approved two new manufacturing facilities in January 2025, expected to alleviate 15% of shortages by Q3 2025.
Looking ahead: challenges and hope
Despite these efforts, the future is uncertain. The Review on Antimicrobial Resistance a global initiative assessing antimicrobial resistance (2025 update) predicts global antibiotic shortages will increase by 40% by 2030, causing 1.2 million additional deaths annually. The WHO's target of ensuring 70% of antibiotic use comes from the 'Access' group of safer drugs by 2030 remains challenging, with current global usage at only 58%. Industry analysts predict a 22% increase in antibiotic development funding through 2027, but manufacturing infrastructure investments may lag. This means the shortage crisis could get worse before it gets better.
What causes antibiotic shortages?
Antibiotic shortages are caused by manufacturing challenges, economic pressures, and geopolitical events. Regulatory compliance costs have risen 34% over the past decade, while generic antibiotic prices dropped 27% since 2015. This makes it hard for manufacturers to invest in sterile injectable production. Brexit, supply chain disruptions, and lack of incentives for low-profit antibiotics also contribute. The European Court of Auditors noted that 'manufacturers have little incentive to make required investments' due to low market prices.
How do antibiotic shortages affect treatment?
When antibiotics are unavailable, doctors must use alternatives that may be less effective or more toxic. For example, colistin-a last-resort antibiotic with severe side effects-is sometimes used for routine infections. This leads to longer hospital stays, higher complication rates, and increased antibiotic resistance. In low-resource settings, patients may receive no treatment at all, risking death from infections that should be treatable.
Which antibiotics are most commonly in short supply?
Penicillin G benzathine has been in shortage since 2015, affecting syphilis and strep treatments. Amoxicillin and amoxicillin-clavulanate shortages led to 55% and 69% reductions in use globally. Carbapenems-critical for resistant infections-are also scarce. The U.S. FDA lists 147 active antibiotic shortages as of December 2024, with penicillin derivatives and injectable antibiotics being most affected.
Are there regional differences in antibiotic shortages?
Yes. The WHO South-East Asian and Eastern Mediterranean regions have the highest resistance rates (1 in 3 infections), while Africa has 1 in 5. The European Economic Area reports 28 countries with shortages (14 critical), and the U.S. has 147 active shortages. Low- and middle-income countries face compounded challenges, with 70% of antibiotics already inaccessible, creating a 'syndemic' of resistance and under-treatment.
What solutions are being implemented?
Antimicrobial stewardship programs (ASPs) help hospitals optimize antibiotic use. California's regional sharing network reduced critical shortages by 43%. The WHO's five-point action plan includes a $500 million Global Antibiotic Supply Security Initiative. The U.S. FDA approved new manufacturing facilities expected to alleviate 15% of shortages by Q3 2025. Industry analysts predict a 22% increase in antibiotic development funding through 2027 via public-private partnerships.
Can antibiotic resistance be reduced?
Yes, but it requires global action. Overuse of antibiotics accelerates resistance. The WHO's 'Access' group of safer antibiotics aims to ensure 70% of use by 2030, but current usage is only 58%. Better diagnostics, stewardship programs, and reducing unnecessary antibiotic use in agriculture are key. The Review on Antimicrobial Resistance warns that without intervention, resistance will continue rising, causing 1.2 million additional deaths annually by 2030.
How do hospitals manage antibiotic shortages?
Hospitals use antimicrobial stewardship programs to monitor usage and prioritize critical drugs. Some have regional sharing networks for emergency distribution. Johns Hopkins Hospital reduced unnecessary broad-spectrum antibiotic use by 37% during shortages through rapid diagnostics. Pharmacists also work with doctors to find alternatives, though this often increases workload and complication risks.
What can patients do during antibiotic shortages?
Patients should not demand antibiotics unnecessarily. Follow doctors' advice on treatment options. If shortages affect your medication, ask about alternatives or clinical trials. Support public health initiatives promoting antibiotic stewardship. Avoid self-medicating, as this worsens resistance. Stay informed through reliable sources like the WHO or CDC for updates on shortages in your region.
Is there hope for resolving the shortage crisis?
Yes, but it requires coordinated global effort. New manufacturing facilities, increased funding for antibiotic development, and policy changes could help. The WHO's initiatives and public-private partnerships show promise. However, the Review on Antimicrobial Resistance warns that without significant intervention, shortages will increase 40% by 2030. Addressing the economic incentives for manufacturers and improving global surveillance are critical steps forward.
How does antibiotic resistance relate to shortages?
Antibiotic resistance and shortages create a dangerous cycle. Resistance makes existing antibiotics ineffective, increasing demand for alternatives. Shortages force doctors to use broader-spectrum drugs, which accelerates resistance. For example, when third-generation cephalosporins are unavailable, doctors use carbapenems-driving resistance to these last-resort drugs. The WHO Global Antibiotic Resistance Surveillance Report 2025 found resistance rose in over 40% of pathogen-antibiotic combinations between 2018-2023, with shortages worsening the problem globally.
