When your child gets pneumonia or you develop a urinary tract infection, you expect antibiotics to work. But in 2025, that’s no longer a guarantee. Across the U.S., Europe, and low-income countries, essential antibiotics are running out. Not because they’re obsolete - but because no one is making them anymore. And when these drugs disappear, people die from infections that should be easy to cure.
Why Antibiotics Are Disappearing
Antibiotics aren’t like other medicines. They’re cheap. They’re old. And they’re made in bulk by factories that barely make a profit. 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 companies make far more money selling cancer drugs, diabetes pills, or weight-loss injections than they do selling penicillin or amoxicillin. The math is brutal. Generic antibiotics have dropped in price by 27% since 2015. But the cost to meet safety standards? Up 34%. Factories that produce sterile injectables need clean rooms, strict controls, and trained staff. Fewer companies are willing to invest when they can’t charge enough to cover it. The result? Just a handful of manufacturers worldwide make most of the world’s antibiotics - and if one plant shuts down, entire countries face shortages. Brexit made it worse. In the UK, antibiotic shortages jumped from 648 in 2020 to 1,634 in 2023. The European Economic Area reports 28 countries are now dealing with shortages, with 14 calling them critical. In the U.S., the FDA listed 147 active antibiotic shortages by December 2024 - the highest in a decade.What’s Running Out
Some drugs are vanishing for years. Penicillin G benzathine has been in short supply since 2015. It’s the only treatment for syphilis in pregnant women - and without it, babies are born with preventable, life-threatening infections. Amoxicillin, the most common antibiotic for ear infections and pneumonia, saw use drop by 55% across 22 databases after its 2023 shortage. Amoxicillin with clavulanate? Down 69%. Even more alarming are the drugs used for resistant infections. Third-generation cephalosporins - once the go-to for E. coli and K. pneumoniae - are failing. Over 40% of E. coli and 55% of K. pneumoniae are now resistant to them. When those fail, doctors turn to carbapenems. But carbapenems are harder to make, more expensive, and already in short supply. Every time a doctor uses one out of necessity, it pushes bacteria closer to total resistance.The Human Cost
It’s not theoretical. In California, Dr. Sarah Chen told the American Public Health Association she had to use colistin - a toxic, last-resort antibiotic - to treat a simple UTI. Colistin can damage kidneys. It’s not supposed to be used unless there’s no other option. But when first-line antibiotics vanish, there’s no other option. In rural Kenya, nurses are sending patients home without antibiotics because the hospital ran out of penicillin. One mother in Mumbai waited 72 hours for azithromycin to treat her child’s pneumonia. By the time it arrived, the infection had worsened. Her child ended up in intensive care. In U.S. hospitals, 78% of pharmacists say they’ve had to change treatment plans because of shortages. 62% report more patients getting sicker or staying longer in the hospital. In the UK, a physician on Reddit described rationing amoxicillin - giving only half the dose to some kids so others could get enough. That’s not medicine. That’s triage.
Why This Is Worse Than Other Drug Shortages
If you can’t get a blood pressure pill, you might switch to another. If your insulin runs out, there are alternatives. But with antibiotics, you often have no backup. If a drug is the only one that works against a specific bacteria - and it’s gone - you’re out of luck. And here’s the cruel twist: when doctors can’t use the right antibiotic, they use broader ones. That kills more good bacteria, speeds up resistance, and makes future infections harder to treat. It’s a cycle. Shortages lead to misuse. Misuse leads to resistance. Resistance leads to more shortages. The World Health Organization calls this a "syndemic" - a deadly mix of under-treatment and over-resistance. In low- and middle-income countries, 70% of antibiotics are already inaccessible. In high-income nations, shortages are temporary. But in poorer regions, they’re permanent.What’s Being Done
The WHO announced a five-point plan in October 2025, including a $500 million Global Antibiotic Supply Security Initiative to be launched by 2027. The U.S. FDA approved two new manufacturing facilities in January 2025 - they’re expected to cover 15% of current shortages by late 2025. The European Commission is pushing new rules to guarantee production of essential antibiotics. Hospitals are trying too. Johns Hopkins reduced unnecessary broad-spectrum antibiotic use by 37% during shortages by using rapid diagnostic tests. These tests tell doctors within hours whether an infection is bacterial or viral - so they don’t prescribe antibiotics unless they’re truly needed. California set up a regional sharing network in 2024. It cut critical shortage impacts by 43% among participating hospitals. But these are fixes, not solutions. Antibiotic stewardship programs are now in 82% of U.S. hospitals - but only 37% meet all WHO standards. Most still lack trained staff, real-time data, or enough time to manage the chaos.
What You Can Do
You can’t fix the supply chain. But you can help break the cycle of resistance.- Don’t demand antibiotics for colds or flu. These are viral. Antibiotics won’t help - and every unnecessary pill adds to the problem.
- Take your full course. If you’re prescribed antibiotics, finish them. Even if you feel better. Stopping early lets surviving bacteria become resistant.
- Ask if a narrow-spectrum drug is available. If your doctor prescribes a broad-spectrum antibiotic, ask if a targeted one exists. It reduces collateral damage to your body’s good bacteria.
- Support policies that fund antibiotic production. Write to your representatives. Vote for leaders who prioritize public health over corporate profits.
What’s Coming Next
Without major changes, global antibiotic shortages will rise 40% by 2030. The Review on Antimicrobial Resistance predicts 1.2 million extra deaths each year from infections we could once cure. The WHO’s goal - getting 70% of antibiotic use from the "Access" group of safer, targeted drugs - is at only 58% today. New funding is coming. New factories are being built. But manufacturing infrastructure takes years. And resistance doesn’t wait. We’re not just running out of drugs. We’re running out of time to protect the most basic tool in modern medicine. The next infection you get might not respond to anything. And if that happens, it won’t be because science failed. It’ll be because we stopped caring.Why are antibiotics in short supply when we still need them?
Antibiotics are cheap, old, and made by a few manufacturers with thin profit margins. The cost to meet safety standards has gone up 34% since 2015, while prices have dropped 27%. Companies make more money selling other drugs, so they stop making antibiotics. When one factory shuts down, global shortages follow.
What antibiotics are currently in shortest supply?
Penicillin G benzathine (used for syphilis in pregnancy), amoxicillin, amoxicillin-clavulanate, and third-generation cephalosporins are among the most critically short. Carbapenems - used as last-resort drugs - are also running low. The U.S. FDA listed 147 active antibiotic shortages as of December 2024.
Are antibiotic shortages worse in poor countries?
Yes. While high-income countries may import or ration antibiotics, 70% of people in low- and middle-income countries already can’t access the antibiotics they need. Shortages there aren’t temporary - they’re permanent. WHO calls this a "syndemic" of under-treatment and rising resistance.
Can I buy antibiotics online to avoid shortages?
No. Buying antibiotics online is dangerous and often illegal. Many online sellers offer fake, expired, or wrong-dose products. In 2025, the WHO warned that nearly 20% of antibiotics sold online in developing countries are substandard. Always get antibiotics from a licensed pharmacy with a prescription.
What’s being done to fix this crisis?
The WHO launched a $500 million global initiative to secure antibiotic supply by 2027. The U.S. FDA approved two new manufacturing plants expected to cover 15% of shortages by late 2025. Hospitals are using rapid diagnostics and stewardship programs to reduce waste. But long-term solutions require government funding, manufacturing incentives, and global cooperation - none of which are yet fully in place.
How do antibiotic shortages lead to more resistance?
When the right antibiotic isn’t available, doctors use broader-spectrum ones to cover more bacteria. These drugs kill more good bacteria and put pressure on resistant strains to survive and multiply. This accelerates resistance. Shortages force overuse of last-resort drugs - which then become useless faster.
Oliver Damon
December 7 2025The structural failure here isn't just corporate greed-it's a misalignment of incentive structures in pharmaceutical R&D. Antibiotics are public goods with non-excludable benefits, yet they're treated like private commodities. The market fails because the social return vastly exceeds the private return. We need prize funds, advance market commitments, or even public manufacturing trusts. Without redefining value beyond quarterly earnings, we're just rearranging deck chairs on the Titanic.