Even with flu cases on the rise, amoxicillin isn’t necessarily the answer, North Bay expert says

North Bay infectious disease specialist Dr. Gary Green has a bit of advice for parents — your kids don’t need antibiotics if they have the flu or any other respiratory viral illness.

Now, if their flu is followed by a secondary bacterial infection, then a prescription of something like amoxicillin — which in some parts of the country is currently in short supply — could be needed, said Green, who works for Sutter Health.

Green said he suspects overprescribing of antibiotics, in some cases to appease worried parents, is one of the reasons there’s a national shortage of amoxicillin. He said thus far there have been no reports of local shortages of the antibiotic at Sutter Health pharmacies.

“I would say that 30% to 50% of antibiotic prescriptions are not appropriate,” he said. “During the first five days of something like the flu, antibiotics don’t help and they shouldn’t be getting it. It’s not indicated and it doesn’t help with all this RSV (respiratory syncytial virus) we’re seeing.”

Late last month, the U.S. Food and Drug Administration added amoxicillin, commonly used to treat strep throat and other bacterial infections, to its Drug Shortage Database, in part because of a spike in demand amid rising cases of RSV.

The shortage has raised concerns about its availability for children suffering bacterial infections.

Dr. Kismet Baldwin, Sonoma County’s deputy health officer, said she has not heard any reports from local providers about a shortage. Baldwin also pointed out that amoxicillin should not be used to treat viral infections such as RSV, the flu or COVID-19.

“I have heard that there may be a national shortage of Amoxicillin, but haven’t heard anything from our providers so far about the shortage,” she said in an email.

Santa Rosa City Schools District officials said Friday they’re not seeing any more student absences than they usually do this time of year.

“We are experiencing similar things that we've seen in previous years, when the weather changes. I haven't noticed anything beyond that,” said Kimberly Clissold, principal at Santa Rosa High School.

Jeremy Decker, superintendent of Windsor Unified School, also said his district schools are not seeing “anything abnormal regarding absent students because of the flu at this time.”

But flu and RSV are definitely on the rise, and sooner than usual, said Kathryn Pack, health program manager for the county’s epidemiology team.

During October, the share of influenza tests at statewide clinical surveillance sites that were positive reached nearly 10%, while the share of positive RVS tests at these sites reached about 17%.

“The highest rates of influenza activity are currently in Southern California. However, we are also seeing increases in influenza-like illness locally,” Pack said in an email.

Pack said all surveillance testing sites in Sonoma County have observed increases in flu-like illness over the past three weeks. Also, flu-related hospitalizations have started to increase.

On Thursday, there were 10 flu hospitalizations in Sonoma County, compared to only one on Oct. 22.

Kaiser Permanente, Sonoma County’s largest primary care system, said on Friday that rates of influenza infection are currently low across Northern California, but that could change at any time. With the weather getting colder and flu season quickly approaching, the health care giant encouraged local residents to get the flu vaccine, as well as the COVID-19 booster.

Kaiser said everyone 6 months and older should get a flu shot each year. “This is especially important for pregnant women, children, older adults, and people with chronic conditions such as asthma and diabetes, or kidney, heart, or lung disease,” a company representative said in an email.

Green and other local physicians said this year could see flu and other respiratory viral infections rebound after a period of dormancy during the pandemic. He said he hopes antibiotics like amoxicillin are used more appropriately going forward. More flu and RSV means the possibility of more secondary bacterial infections developing.

“Sometimes after a severe viral infection, you could get a secondary bacterial infection. That’s when (antibiotics are) appropriate,” he said.

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.