The European Medicines Agency is investigating a chronic shortage in antibiotics across Europe, where almost every country is reporting gaps in supplies.

Twenty-five out of the 27 EU countries have reported local shortages, the agency’s Chief Medical Officer Steffen Thirstrup told a press briefing on Friday.

“We are not at the bottom of the root cause yet, but we know that there is an increased demand,” said Thirstrup, referencing an increase in cases of Strep A infections.

Earlier this week, the European Center for Disease Prevention and Control and the World Health Organization warned of the rise in serious cases of invasive Strep A infections, with several children dying from the disease.

The antibiotics amoxicillin and amoxicillin with clavulanic acid are both in short supply across the bloc. As well as treating Strep A, they are used to treat infections of the ears, lungs, sinus, skin, and urinary tract.

“We know from a few of the manufacturers that they have manufacturing capacity issues, some of them related to lack of staff,” said Thirstrup.

“So, it's not so much … being able to produce the product, but producing the final product and bringing it to the market,” he added.

Under its expanded remit due to the pandemic, the EMA now plays a role in monitoring medicines shortages in Europe and coordinating activities to prevent shortages or mitigate their effects.

Marco Cavaleri, head of health threats at the agency, warned however that antibiotics must only be used prudently, and not to treat viral infections. Overuse and misuse of antibiotic is one of the key drivers of the antimicrobial resistance.