Provider Briefing: The Augmentin Shortage in 2026

Amoxicillin/Clavulanate (Augmentin) remains one of the most widely prescribed antibiotics in outpatient settings—and one of the most persistently affected by supply disruptions. For providers navigating this shortage daily, this briefing covers the current status, timeline, prescribing considerations, and tools to help your patients access treatment.

Shortage Timeline

The current Amoxicillin/Clavulanate shortage has its roots in the 2022 "triple-demic" when simultaneous surges of RSV, influenza, and COVID-19 drove unprecedented demand for oral antibiotics. Key milestones:

• Late 2022: Initial shortage reported for amoxicillin oral suspensions, followed by Amoxicillin/Clavulanate liquid formulations
• 2023: ASHP listed Amoxicillin/Clavulanate oral presentations as an active shortage. Multiple manufacturers placed products on back order.
• 2024: Intermittent availability for tablets; sustained shortage for pediatric suspensions. FDA Drug Shortage Database listed the drug continuously.
• 2025: FDA approved the first National Priority Voucher under its domestic manufacturing pilot program, specifically targeting amoxicillin and Augmentin XR production capacity. Teva, Sandoz, Aurobindo, and Dr. Reddy's remained active suppliers with intermittent back orders.
• Early 2026: Shortage continues. ASHP reports Teva's suspension products on back order with estimated release in late 2025 (now delayed). Tablet formulations are more available but spot shortages persist during respiratory season. Amoxicillin capsules (500 mg) also affected with back orders extending into early 2026.

Prescribing Implications

The shortage has several clinical implications for prescribers:

Formulation Considerations

Not all Augmentin formulations are equally affected. Current availability generally follows this pattern:

• 875/125 mg tablets: Most available; first-line for adults
• 500/125 mg tablets: Good availability; alternative dosing (q8h vs q12h)
• 250/125 mg tablets: Generally available
• Augmentin XR (1000/62.5 mg): Limited availability; Dr. Reddy's is a current supplier
• Oral suspensions (all strengths): Most affected; back orders from multiple manufacturers
• ES-600 suspension: Severely limited

Clinical note: The 250 mg and 500 mg tablets contain the same amount of clavulanate (125 mg each). Two 250 mg tablets are not equivalent to one 500 mg tablet due to the doubled clavulanate dose, which increases GI side effects. Always prescribe the specific tablet strength needed.

Pediatric Prescribing Challenges

The suspension shortage is most impactful for pediatric patients who cannot swallow tablets. Consider:

• For children who can swallow chewable tablets, check availability of chewable formulations
• Compounding pharmacies may be able to prepare Amoxicillin/Clavulanate suspensions from tablet stock or raw ingredients
• Alternative oral antibiotics in liquid form (Cefdinir suspension, Azithromycin suspension) may be more readily available

Antibiotic Stewardship

The shortage reinforces the importance of prescribing Augmentin only when the broader spectrum (vs. plain amoxicillin) is clinically indicated. Conditions where plain amoxicillin may be sufficient include:

• Group A streptococcal pharyngitis
• Uncomplicated acute otitis media in low-risk patients
• Mild community-acquired pneumonia in otherwise healthy patients

Reserve Amoxicillin/Clavulanate for situations where beta-lactamase-producing organisms are likely: recurrent or treatment-failure sinusitis, complicated otitis media, bite wounds, and diabetic foot infections.

Current Availability Picture

As of early 2026, the ASHP Drug Shortage Database lists Amoxicillin/Clavulanate oral presentations as an active shortage. Key manufacturer updates:

• Teva: Suspension products on back order; estimated release dates have been pushed back multiple times
• Dr. Reddy's: Augmentin XR and generic extended-release tablets available in limited quantities
• Sandoz, Aurobindo: Tablet formulations intermittently available; supply varies by distributor

The FDA's approval of a domestic manufacturing voucher for amoxicillin and Augmentin XR signals long-term commitment to supply stability, but new production capacity is not expected to materially impact supply before late 2026 at the earliest.

Cost and Access Considerations

Generic Amoxicillin/Clavulanate pricing for patients:

• With insurance: $5–$45 copay (covered by ~79% of plans, Tier 1–2)
• Cash price: $15–$97 for 20 tablets (875/125 mg) at retail
• With discount cards: $9–$20 via GoodRx, SingleCare, or similar programs
• Brand Augmentin: $80–$150 for 20 tablets without insurance (rarely necessary given generic availability)

No prior authorization is typically required for generic Amoxicillin/Clavulanate. Patients who face cost barriers can be directed to our savings guide at medfinder.com/blog or to the provider-focused cost guide at medfinder.com/blog.

Tools and Resources for Your Practice

Several tools can help your team manage the shortage:

Real-Time Stock Checking

Medfinder for Providers allows you to check which pharmacies in your patient's area currently have Augmentin in stock. This can be built into your workflow to prevent patients from receiving unfillable prescriptions.

ASHP Drug Shortage Database

The ASHP shortage database (ashp.org/drug-shortages) provides current manufacturer-level updates, estimated release dates, and therapeutic alternatives for Amoxicillin/Clavulanate.

Therapeutic Alternatives Reference

When substitution is necessary, common alternatives by indication:

• Acute bacterial sinusitis: Doxycycline, respiratory fluoroquinolone (Levofloxacin), or high-dose Amoxicillin (if beta-lactamase coverage not essential)
• Acute otitis media: Cefdinir, Cefuroxime, or Azithromycin
• Lower respiratory infections/CAP: Doxycycline, Azithromycin, respiratory fluoroquinolone
• Skin and soft tissue infections: Cephalexin, Clindamycin, TMP-SMX (depending on pathogen)
• UTI: Nitrofurantoin, TMP-SMX, Ciprofloxacin (based on susceptibilities)
• Bite wounds: Doxycycline + Metronidazole, or Moxifloxacin

For a patient-oriented discussion of alternatives, see Alternatives to Augmentin.

Looking Ahead

Several factors suggest gradual improvement in Augmentin supply:

• The FDA's domestic manufacturing initiative should increase U.S.-based production capacity over the next 1–2 years
• Multiple generic manufacturers remain active, and new ANDA approvals may add suppliers
• Post-pandemic demand normalization should reduce seasonal strain on supply

However, the underlying vulnerability of the antibiotic supply chain—concentrated overseas manufacturing, thin margins discouraging investment, and seasonal demand volatility—means that intermittent shortages may recur even after the current crisis resolves.

Final Thoughts

The Augmentin shortage requires prescribers to be proactive: verify availability before prescribing when possible, consider formulation flexibility, maintain awareness of therapeutic alternatives, and direct patients to tools like Medfinder that can help them locate stock quickly.

For a practical workflow guide on helping patients find Augmentin, see our companion article: How to Help Your Patients Find Augmentin in Stock.