Pharmacists can supply two additional alternative penicillin medicines to ensure there is enough of the drug to treat Strep A cases.
It comes as cases of scarlet fever, which is caused by Strep A bacteria, is three times the normal rate – causing temporary shortages in some chemists.
The SSP (serious shortage protocols) now cover a total of five medicines, in addition to the three released earlier this week, with one tablet now on the Ministry of Health’s list.
This means that pharmacists can supply an alternative form of penicillin without the patient having to go back to a GP if the prescribed one has run out.
SSPs are standard procedure for dealing with temporary supply problems, health chiefs say.
At least 19 children across the UK have now died from invasive Strep A (also known as iGAS), a more serious form of the infection that enters parts of the body such as the lungs and blood.
However, the vast majority of cases can be easily treated and are relatively mild, with common symptoms such as sore throat, rash and fever.
Professor Susan Hopkins, chief medical adviser at the UK Health Security Agency (UKHSA), said just over 7,500 cases of scarlet fever had been notified – but that the figure was “probably an underestimate”.
“We’ve had a lot of reports coming in over the last few days so we expect it to be even higher,” she told the BBC’s Today program on Saturday.
“That’s about three times higher than the same time in a normal season,” she said.
What is Strep A and what are the symptoms of the bacterial infection?
Strep A is common and generally causes mild infections – so why the wave of deaths now?
“The last bad season we had was in 2017 and 18. And in invasive group A strep cases, we’re more than halfway to what we would normally see in an average season.
“We have seen 111 cases in children aged one to four and 74 cases in children aged five to nine.”
Official UKHSA figures for England and Wales show that 1,702 cases of scarlet fever were notified in the week ending 11 December, with 1,352 in the week before that, 1,044 in the week before that and 960 cases in the week ending 20. November – a near doubling of the cases in one month.
The latest weekly figure for iGAS cases was 15, up from 10 the previous week.
Prof Hopkins stressed that most children have a mild disease and said she had an “open mind” about why infections were so high.
Some other experts have suggested that it may be because it is less immunity due to reduced mixing during COVID shutdowns.
Parents are encouraged to vaccinate their children with the flu nasal spray because areas that already roll it out have a lower frequency of Strep A cases.
Professor Hopkins said people with flu infections are more likely to get a secondary infection on top, with children who get flu frequently at higher risk of contracting Strep A.
Children younger than school age can get the vaccine from their GP, while children at school can get it via the school vaccination service.
The SSP penicillin list now includes:
- Phenoxymethylpenicillin 125mg/5ml oral solution
- Phenoxymethylpenicillin 125mg/5ml oral solution, sugar-free
- Phenoxymethylpenicillin 250mg/5ml oral solution
- Phenoxymethylpenicillin 250mg/5ml oral solution, sugar-free
- Phenoxymethylpenicillin 250mg tablets