Amoxicillin shortages in French primary care: a qualitative study of family physicians' behaviors and infectious diseases implications.

INTRODUCTION

Amoxicillin is the first-line antibiotic most commonly prescribed by family physicians (FPs) in France, but recurrent national shortages have disrupted its availability since 2013. Data on FPs' adaptations to these shortages, and their infectious disease consequences, remain scarce.

PATIENTS AND

METHODS

We conducted a qualitative study among 10 FPs practicing in the Hauts-de-Seine and Yvelines departments (France), using semi-structured interviews analyzed with Thomas's general inductive approach.

RESULTS

FPs described a triple uncertainty (drug availability, therapeutic choice, information) which prompted pragmatic prescribing, therapeutic substitution, and reliance on decision-support tools. Shortages reconfigured the physician-pharmacist-patient relation, empowering pharmacists while constraining patients. Substitution toward broader-spectrum antibiotics raised concerns about bacterial resistance, echoed by emerging clinical signals of complicated infections during shortage periods.

CONCLUSION

Structured, real-time information and antimicrobial stewardship-compatible guidance are needed to anticipate future amoxicillin shortages in primary care.