Your Patient Can't Find Amoxicillin/Clavulanate — Here's How You Can Help
As a prescriber, few things are more frustrating than writing a prescription you know is clinically appropriate, only to have your patient call back saying the pharmacy doesn't have it. With Amoxicillin/Clavulanate (Augmentin), this has been an increasingly common scenario since the shortage began in late 2022.
While tablet formulations have stabilized, oral suspensions and extended-release tablets remain inconsistently available in 2026. This guide provides five practical steps you can take to help your patients get the medication they need — plus backup strategies when Amoxicillin/Clavulanate simply can't be found.
Current Availability Snapshot
Before diving into solutions, here's where things stand:
- 875/125 mg tablets: Generally available. This is the most reliable formulation for adult patients.
- 500/125 mg and 250/125 mg tablets: Available from most manufacturers.
- Oral suspensions (all strengths): Intermittent availability. Multiple manufacturers have products on backorder. This is the primary pain point for pediatric prescribing.
- Extended-release tablets (Augmentin XR): Limited availability following Dr. Reddy's market exit.
- Chewable tablets: Sporadic shortages of select strengths.
Why Patients Can't Find It
Understanding the barriers your patients face helps you address them proactively:
- Chain pharmacy stock-outs: High-volume chain pharmacies exhaust their allotments quickly, especially during respiratory season.
- Formulation confusion: Patients may not realize that a different strength or form could be substituted (with prescriber approval).
- Geographic variation: Availability differs significantly by region. Rural areas and underserved communities are disproportionately affected.
- Timing: Pharmacies receive deliveries on set schedules. A patient arriving in the afternoon may miss the morning stock that was available earlier.
5 Steps to Help Your Patients Find Amoxicillin/Clavulanate
Step 1: Verify Availability Before Sending the Prescription
The single most impactful thing you can do is confirm stock before the patient leaves your office. Options include:
- Having your staff call the patient's preferred pharmacy.
- Using Medfinder for Providers to search real-time pharmacy inventory online.
- Asking the patient to check availability on their phone before you finalize the prescription.
This takes 2-3 minutes and prevents the far more time-consuming cycle of callbacks, prior authorizations for alternatives, and patient frustration.
Step 2: Prescribe the Most Available Formulation
When clinically appropriate, default to the formulation with the best supply:
- For adults: 875/125 mg tablets twice daily (the most widely stocked strength).
- For children who can swallow tablets: Consider tablets over suspension when age and weight-appropriate.
- Avoid prescribing extended-release formulations unless specifically indicated (e.g., community-acquired pneumonia per guidelines) — standard tablets at appropriate dosing intervals often achieve comparable outcomes.
Step 3: Recommend Independent and Compounding Pharmacies
When chain pharmacies are out of stock, independent pharmacies often have supply. Reasons include:
- Lower patient volume means stock lasts longer.
- Many independent pharmacies use multiple wholesalers, improving their sourcing flexibility.
- Compounding pharmacies can prepare Amoxicillin/Clavulanate suspensions under FDA's Section 503A shortage guidance — a critical option for pediatric patients.
Consider maintaining a short list of independent and compounding pharmacies in your area to share with patients when needed.
Step 4: Provide a Backup Prescription
For patients at high risk of pharmacy stock-outs (pediatric patients needing suspension, rural patients), consider providing two prescriptions:
- Primary: Amoxicillin/Clavulanate at the desired formulation and dose.
- Backup: An appropriate alternative (e.g., Cefdinir suspension for children) with clear instructions to fill only if the primary is unavailable.
Document this approach in the chart and communicate it clearly to the patient. This empowers patients and pharmacists to act without requiring a callback to your office.
Step 5: Direct Patients to Medfinder
Recommend Medfinder as a tool patients can use independently to search for pharmacies with Amoxicillin/Clavulanate in stock. This is particularly valuable for:
- Patients who are sent home with a prescription and discover their pharmacy is out of stock after hours.
- Patients in areas with multiple pharmacy options who need to identify which one currently has supply.
- Follow-up scenarios where the patient needs a refill and their usual pharmacy's stock may have changed.
Alternative Agents When Amoxicillin/Clavulanate Is Unavailable
When substitution is necessary, the following alternatives are supported by clinical guidelines:
- Cefdinir (Omnicef): Available as capsules and suspension. Broad cephalosporin coverage. Good first-line alternative for sinusitis, otitis media, and lower respiratory infections. Cost: $10-$30 generic.
- Cephalexin (Keflex): First-generation cephalosporin. Appropriate for skin/soft tissue and uncomplicated UTIs. Widely available and inexpensive ($4-$15). Not ideal for resistant respiratory pathogens.
- Azithromycin (Zithromax): Macrolide class. Preferred for penicillin-allergic patients. Convenient 5-day dosing. Growing resistance limits utility for some respiratory infections. Cost: $8-$20.
- Doxycycline: Broad-spectrum tetracycline. Useful for respiratory, skin, and dental infections. Not appropriate for children under 8 or pregnant patients. Cost: $8-$25.
- Amoxicillin alone: For infections where beta-lactamase resistance is not a concern (e.g., streptococcal pharyngitis, uncomplicated dental infections), plain amoxicillin may suffice and has better availability.
For detailed alternative guidance by indication, see our provider shortage briefing.
Workflow Tips for Your Practice
Integrating shortage awareness into your daily workflow doesn't have to be complicated:
- Morning huddle update: Have a staff member check ASHP's shortage list weekly and flag any changes relevant to your common prescribing patterns.
- EHR prescription favorites: Add alternative agents to your quick-order sets so switching takes seconds, not minutes.
- Patient handout: Create a simple one-page handout about the shortage that includes the Medfinder link and instructions for what to do if the pharmacy is out of stock.
- Pharmacy relationships: Build direct communication channels with 2-3 pharmacies your patients frequently use. A quick text or call can confirm availability faster than any database.
- Track outcomes: If you're seeing a pattern of patients unable to fill Amoxicillin/Clavulanate, it may be worth defaulting to an alternative as first-line for certain indications until supply stabilizes.
Final Thoughts
The Amoxicillin/Clavulanate shortage adds friction to an already complex prescribing environment. But with a proactive approach — verifying stock before prescribing, choosing the most available formulation, preparing backup plans, and directing patients to tools like Medfinder — you can significantly reduce the impact on your patients and your practice.
For related resources, see:
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