Provider Briefing: The Amoxicillin/Clavulanate Shortage in 2026

The ongoing Amoxicillin/Clavulanate shortage continues to affect prescribing patterns and patient access heading into 2026. While the most acute phase of the shortage has passed, clinicians should remain aware of formulation-specific supply gaps, particularly for oral suspensions and extended-release tablets. This briefing provides an updated overview for prescribers navigating the current landscape.

Shortage Timeline

The current shortage of Amoxicillin/Clavulanate oral formulations began in October 2022, driven by an unprecedented respiratory illness season coinciding with manufacturing constraints. Key milestones include:

• October 2022: ASHP first reports shortages of amoxicillin oral presentations, followed by amoxicillin/clavulanate formulations.
• Winter 2022-2023: Peak shortage period. Triple epidemic of influenza, RSV, and COVID-19 drives demand far beyond manufacturing capacity, particularly for pediatric suspensions.
• 2023-2024: Gradual improvement in tablet availability. Suspensions remain intermittently backordered. FDA issues guidance authorizing compounding of beta-lactam products under Section 503A.
• 2025: Dr. Reddy's Laboratories discontinues amoxicillin/clavulanate extended-release tablets. Teva suspensions remain on backorder with estimated release dates repeatedly deferred. ASHP reports seven documented shortage events for amoxicillin products.
• Early 2026: Standard tablets (250/125, 500/125, 875/125 mg) are generally available. Oral suspensions and XR formulations remain supply-constrained. FDA approves first National Priority Voucher to support domestic antibiotic manufacturing.

Prescribing Implications

The shortage has several practical implications for clinical decision-making:

Formulation Selection

When prescribing Amoxicillin/Clavulanate, consider the following:

• 875/125 mg tablets have the most reliable supply and should be the default for adults when clinically appropriate.
• Oral suspensions remain the most affected formulation. For pediatric patients who cannot swallow tablets, consider whether age-appropriate alternatives exist or whether a compounding pharmacy is accessible.
• Extended-release tablets (1000/62.5 mg) have limited generic availability following Dr. Reddy's market exit. Consider whether standard-release formulations at appropriate dosing intervals can achieve comparable therapeutic goals.

Empiric Therapy Considerations

Given ongoing supply uncertainty, it's prudent to verify availability before prescribing — particularly for suspensions. Options include:

• Confirming stock with the patient's preferred pharmacy before finalizing the prescription.
• Including a "dispense as written" note only when clinically necessary, as this can limit the pharmacist's ability to substitute available strengths.
• Providing patients with an alternative prescription (e.g., Cefdinir suspension) as a backup if the primary choice is unavailable.

Current Availability Picture

As of early 2026, ASHP continues to list amoxicillin/clavulanate oral presentations as shortage items. The situation by formulation:

• Tablets (all strengths): Generally available from multiple manufacturers (Sandoz, Aurobindo, Teva, others). Sporadic local outages possible.
• Oral suspensions: Intermittent availability. Multiple strengths backordered from Teva. Other manufacturers supplying limited quantities.
• Chewable tablets: Periodic shortages of certain strengths.
• XR tablets: Limited availability. Fewer generic manufacturers in the market.

Cost and Access Considerations

Amoxicillin/Clavulanate remains an affordable generic antibiotic for most patients:

• Insured patients: Typically Tier 1 formulary placement with $0-$15 copays. No prior authorization required for standard formulations.
• Uninsured patients: Cash price of $20-$60 for a standard course. Discount cards (GoodRx, SingleCare) can reduce this to $10-$25.
• Cost is rarely the access barrier — availability is. Direct patients to tools that help locate pharmacies with current stock.

Tools and Resources for Providers

Several resources can help you and your patients navigate the shortage:

• Medfinder for Providers — Real-time pharmacy stock search tool. Recommend to patients or use in your workflow to verify availability before prescribing.
• ASHP Drug Shortages Resource Center — Current shortage details and manufacturer updates at ashp.org.
• FDA Drug Shortages Database — Official shortage listings and expected resolution dates.
• AAP Antibiotic Alternatives Guide — The American Academy of Pediatrics maintains antibiotic options for pediatric conditions, helpful when suspensions are unavailable.

Alternative Agents

When Amoxicillin/Clavulanate is unavailable, consider the following evidence-based alternatives based on indication:

• Acute bacterial sinusitis: Cefdinir, Cefpodoxime, or Azithromycin (if penicillin-allergic). High-dose amoxicillin alone may suffice for non-resistant organisms.
• Acute otitis media: Cefdinir, Cefuroxime, or Ceftriaxone IM (for treatment failure or severe cases).
• Community-acquired pneumonia: Doxycycline, Azithromycin, or a respiratory fluoroquinolone (Levofloxacin) for appropriate patients.
• Skin and soft tissue infections: Cephalexin for uncomplicated cases. Clindamycin or TMP-SMX if MRSA coverage needed.
• Dental infections: Amoxicillin alone, Clindamycin, or Metronidazole depending on the clinical scenario.

For a patient-facing overview of alternatives, see: Alternatives to Amoxicillin/Clavulanate.

Workflow Tips for Your Practice

To minimize disruption for your patients:

1. Check availability first. A quick call to the pharmacy or a check on Medfinder before sending the script can prevent patient frustration.
2. Consider backup prescriptions. For patients likely to face access issues, provide a backup prescription for an alternative agent with clear instructions on when to use it.
3. Communicate with pharmacists. Pharmacists can often suggest therapeutic substitutions within formulary. Collaborative practice agreements, where available, can streamline this process.
4. Educate patients. Let patients know the shortage exists so they aren't blindsided at the pharmacy. Share resources like Medfinder.

Looking Ahead

The structural factors driving antibiotic shortages — low-margin generics, concentrated overseas manufacturing, fragile supply chains — are not going to resolve quickly. However, several developments are encouraging:

• The FDA's National Priority Voucher program is incentivizing domestic antibiotic production.
• Congressional attention to drug shortage issues has increased, with potential legislative action on supply chain transparency.
• Some manufacturers are investing in expanded capacity for high-demand generics.

In the meantime, providers should plan for continued intermittent supply disruptions and maintain familiarity with alternative regimens.

Final Thoughts

The Amoxicillin/Clavulanate shortage requires ongoing vigilance from prescribers. While tablet formulations are largely accessible, suspension and XR shortages continue to present challenges — particularly in pediatric care. Proactive prescribing, patient education, and use of availability tools like Medfinder can help minimize the impact on patient outcomes.

For the patient-facing perspective, see our shortage update for patients. For practical steps on helping patients locate medication, read our provider's guide to helping patients find Amoxicillin/Clavulanate in stock.