When a child gets pneumonia or a woman develops a urinary tract infection, the expectation is simple: a few days of antibiotics, and they’ll feel better. But in 2025, that’s no longer guaranteed. Across the UK, the US, and parts of Africa and Asia, hospitals are running out of basic antibiotics. Penicillin. Amoxicillin. Cephalexin. These aren’t rare or expensive drugs-they’re the backbone of modern medicine. And they’re disappearing.
Why Antibiotics Are Vanishing
Antibiotics aren’t like other medicines. They’re cheap, mass-produced, and used in huge volumes. That’s exactly why manufacturers don’t make them anymore. In 2024, the global antibiotic market was worth $38.7 billion-but it grew just 1.2% since 2019. Meanwhile, the rest of the pharmaceutical industry grew at 5.7%. Why? Because profit margins on antibiotics are razor-thin. A single course of amoxicillin might cost less than £2. Manufacturers in India and China produce billions of doses, but with prices down 27% since 2015 and regulatory costs up 34%, many have shut down production lines. Brexit made it worse in the UK. In 2020, there were 648 drug shortages. By 2023, that number jumped to 1,634. A third of those were antibiotics. The European Court of Auditors found that many factories producing sterile injectables-like penicillin G benzathine-were outdated or underfunded. No one wants to spend millions upgrading a plant that makes a drug selling for pennies.What Happens When Antibiotics Disappear
When a hospital runs out of amoxicillin, doctors don’t just wait. They switch. They use stronger antibiotics-broader-spectrum ones like carbapenems or colistin. These aren’t just alternatives. They’re last-resort drugs. And using them too often is what’s fueling the rise in antibiotic resistance. In 2023, one in six bacterial infections worldwide didn’t respond to standard antibiotics. For urinary tract infections, it was one in three. In the UK, doctors are now seeing E. coli strains resistant to first-line drugs they’ve used for decades. When cephalosporins fail, carbapenems become the only option. But carbapenems are already losing effectiveness. A 2024 study showed that over 40% of E. coli and 55% of K. pneumoniae are now resistant to them globally. It’s not just about resistance. It’s about survival. A nurse in rural Kenya told the WHO: “When penicillin isn’t available, we send patients home. We know they might die.” In Mumbai, a mother’s child waited 72 hours for azithromycin. The pneumonia worsened. They ended up in intensive care. In California, an infectious disease specialist told the APHA forum she had to use colistin-a toxic, last-resort drug-for a simple UTI. That’s not medicine. That’s triage.Who’s Affected the Most
High-income countries like the US and UK have some tools to cope. They can import drugs, ration supplies, or shift to alternatives. But it’s messy. A 2025 survey found 78% of US hospital pharmacists had to change treatment plans because of shortages. 62% reported more patients getting sicker or staying longer in hospital. Low- and middle-income countries don’t have that luxury. In Africa, 1 in 5 infections are resistant to antibiotics. But access is even worse-70% of antibiotics are already unavailable in many regions. There’s no backup. No import system. No pharmacy stockpile. People die from infections that were curable 20 years ago. The WHO calls this a “syndemic”-a deadly mix of resistance and under-treatment. Where surveillance is weak, resistance grows. Where access is poor, people use leftover pills or share drugs. That makes resistance worse. It’s a loop no one talks about enough.
What Hospitals Are Doing to Survive
Some hospitals are fighting back. Johns Hopkins set up an antimicrobial stewardship program that cut unnecessary broad-spectrum antibiotic use by 37% during shortages. They used rapid diagnostic tests to tell if an infection was bacterial or viral-before prescribing anything. That saved antibiotics and reduced resistance. In California, 12 hospitals started sharing antibiotic stockpiles. If one ran out of amoxicillin, another could send a shipment within 24 hours. That cut critical shortage impacts by 43%. But these solutions aren’t easy. Setting up a good stewardship program takes 6 to 12 months. Pharmacists are working 22% more hours just to track supplies. Rationing decisions are heartbreaking. Do you give the last dose to the 80-year-old with pneumonia-or the 6-year-old with sepsis? Only 37% of US hospitals meet all WHO standards for antibiotic stewardship. Most are just winging it.What’s Being Done-And What’s Not
The WHO announced a five-point plan in October 2025, including a $500 million Global Antibiotic Supply Security Initiative. The EU is pushing its Pharmaceutical Strategy for Europe, aiming to fix shortages by 2026. The FDA approved two new antibiotic manufacturing plants in January 2025-expected to cover 15% of current shortages by late 2025. But here’s the problem: these are fixes for symptoms, not causes. The market still doesn’t reward antibiotic production. Companies won’t invest in making cheap drugs unless they’re paid to. The Review on Antimicrobial Resistance predicts that without real economic change, antibiotic shortages will rise 40% by 2030-and cause 1.2 million extra deaths each year. The WHO wants 70% of antibiotic use to come from “Access” group drugs-safe, effective, and low-resistance options. Right now, it’s only 58%. We’re moving backward.
What You Can Do
You won’t fix the global supply chain. But you can help stop the cycle. Don’t demand antibiotics for colds or flu. They don’t work. And every unnecessary dose pushes resistance forward. Finish your full course-even if you feel better. Stopping early leaves behind the toughest bacteria. They multiply. Ask your doctor: “Is this really necessary?” If they say yes, ask: “Is there a narrower-spectrum option?” Support policies that pay manufacturers to make essential antibiotics. Vote for leaders who treat drug access as public health, not just commerce.The Bottom Line
Antibiotics are the most taken, most trusted, and most vulnerable drugs in medicine. We’ve treated them like commodities. But they’re not. They’re the foundation of everything-from surgery to chemotherapy to childbirth. When they disappear, so does modern medicine. The next time you hear about a drug shortage, don’t think of it as a supply chain glitch. Think of it as a warning. We’re running out of time to fix this. Not in years. In months.Why are antibiotics running out when we need them more than ever?
Antibiotics are cheap to make but offer tiny profits. Manufacturers have shut down production because regulatory costs have risen 34% since 2015 while prices dropped 27%. With little financial incentive, companies focus on more profitable drugs. This has led to a global decline in production, especially for generic antibiotics that make up 85% of use.
Are there alternatives when antibiotics are in short supply?
Sometimes, but rarely good ones. For common infections like UTIs or ear infections, there are few equally safe and effective substitutes. Doctors often have to use broader-spectrum antibiotics like carbapenems or colistin, which are more toxic and drive resistance. In low-income countries, there are often no alternatives at all.
How do antibiotic shortages increase resistance?
When first-line antibiotics aren’t available, doctors use stronger drugs as backups. Overusing these broad-spectrum antibiotics kills off weaker bacteria but leaves behind the toughest strains. These resistant bacteria multiply and spread. In 2023, over 40% of E. coli and 55% of K. pneumoniae were already resistant to key antibiotics. Shortages accelerate this process.
Is this problem worse in the UK than elsewhere?
The UK is severely affected-especially after Brexit, which increased drug shortages from 648 in 2020 to 1,634 in 2023. But the problem is global. The US had 147 active antibiotic shortages in December 2024. In the EU, 14 countries called shortages “critical.” In low-income countries, 70% of antibiotics are already inaccessible. No region is immune.
What’s being done to fix antibiotic shortages?
The WHO launched a $500 million global initiative in 2025 to secure antibiotic supplies. The EU and US are funding new manufacturing plants. Hospitals are using stewardship programs to reduce waste. California’s regional sharing network cut critical shortages by 43%. But these are temporary fixes. Without paying manufacturers fairly to produce low-cost antibiotics, shortages will keep growing.
Can I help prevent antibiotic shortages?
Yes. Don’t ask for antibiotics for viral infections like colds or flu. Always finish your full course-even if you feel better. Ask your doctor if a narrower-spectrum antibiotic is an option. Support policies that fund essential antibiotic production. Your choices reduce unnecessary use, which slows resistance and eases pressure on the supply.
