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The Public Health Agency of Sweden

Priority list of antibiotic products at risk for lack of availability in Sweden

To help strengthen Sweden’s antibiotic market and maintain access to important antibiotic products, the Public Health Agency of Sweden regularly produces a priority list. The list identifies the antibiotics that are both at risk of becoming difficult to access – and are critical for Swedish healthcare.

The list was updated in May 2026. Formulations mainly intended for children were given high priority.

Which antibiotics were reviewed?

To identify which antibiotic products are particularly valuable for Swedish healthcare, the Public Health Agency of Sweden, within the framework of EU-JAMRAI 2, in collaboration with Platinea and together with an advisory external reference group, has conducted a clinical evaluation of antibiotic products based on their substance, dosage form and strength. The focus was on low-selling products. The substances may also be marketed in other strengths.

The analysis included all medicines (ATC codes) that contain an antibacterial substance and are used to treat or prevent bacterial infection, including systemic and topical formulations. Medicines intended for the treatment of tuberculosis (TB) were also included. Products specifically intended for direct application to the eyes were excluded.
At the recent update, antibiotics (substance, formulation, strength) were reviewed that are:

Approved in Sweden

  • and have total sales less than SEK 4,000,000 during a 12-month period (October 2024-September 2025), and
  • are marketed by a maximum of three marketing authorization holders (MAHs).

Not approved in Sweden, but are

  • frequently prescribed on a named-patient basis during the corresponding 12-month period, or
  • have been withdrawn from the market since October 2023.

Parallel imported products were excluded from the review due to uncertain supply.

Advisory expert group

Seventeen clinically active experts appointed by each specialist association formed the external advisory group (infectious disease physicians including TB specialists, general practitioners, pediatricians, clinical microbiologists and dentists). The reference group assessed which antibiotics (at the level substance, formulation and strength) were at risk of short- or long-term shortage or already have insufficient availability. The assessment is based on:

  • Clinical value: how important the product is for treating or preventing bacterial infections.
  • Consequences for healthcare: what effects it would have if the antibiotic product was not available.

The expert group scored all products on a scale of 0–2. The individual scores were compiled and categorised by the Public Health Agency. Categories A–C imply the following rating:

  • A. Very valuable to have available in Sweden. Significant clinical consequences if the product is not available.
  • B. Valuable to have available in Sweden. Clinical and/or logistical (resource-related) consequences if the product is not available.
  • C. There is usually a relatively equivalent alternative.

In addition, the experts themselves were allowed to suggest products that they considered important to have available in Sweden.

Results 2026

A total of 112 antibiotic products were assessed, of which 100 are approved in Sweden. Of the 36 approved products in category A, 22 were not interchangeable according to the Medical Products Agency's definition and 12 of these were formulations aimed primarily for treatment of children. Twelve antibiotic products that are not approved in Sweden are on the priority list, Table 2. Of these, eight were categorized as A, of which four are oral solutions/mixtures. The experts proposed a total of nine additional products that are missing in Sweden, of which seven were adapted for children.

The assessment showed, among other things, that formulations aimed for treatment of children are given high priority.

Formulation (se table 1, table 2 and table 3): What we refer to as oral solutions are typically supplied as powders or granules for oral solution or oral suspension. The liquid preparation is then reconstituted by pharmacists or healthcare professionals at pharmacies or hospitals prior to use.

Table 1. Approved antibiotic products with risk of uncertain availability classified as category A, B or C in the clinical evaluation.
ATC Substance Formulation Strength Category A-C
J01CR02 amoxicillin-clavulanic acid oral solution 50 mg/ml + 13 mg/ml A
J01CR02 amoxicillin-clavulanic acid oral solution 80 mg/ml + 12 mg/ml A
J01FA10 azithromycin oral solution 40 mg/ml A
J01DD08 cefixime oral solution 20 mg/ml A
J01MA02 ciprofloxacin oral solution 50 mg/ml A
J01FA01 erythromycin oral solution 200 mg/ml A
A07AA12 fidaxomicin oral solution 40 mg/ml A
J01FF01 clindamycin oral solution 15 mg/ml A
P01AB01 metronidazole oral solution 40 mg/ml A
J01EA01 trimethoprim oral solution 10 mg/ml A
J01EE01 trimethoprim-sulfamethoxazole oral solution 8 mg/ml+40 mg/ml A
J01GB06 amikacin parenteral formulation 250 mg/ml A
J01DF51 aztreonam-avibactam parenteral formulation 1,5 g/0,5 g A
J01CE01 bensylpenicillin parenteral formulation 1 g A
J01DD02 ceftazidime parenteral formulation 2 g A
J01DD52 ceftazidime-avibactam parenteral formulation 2 g- 0,5 g A
J01DD04 ceftriaxone parenteral formulation 2 g A
J01MA02 ciprofloxacin parenteral formulation 2 mg/ml A
J01FA01 erythromycin parenteral formulation 1 g A
J01FF01 clindamycin parenteral formulation 150 mg/ml A
J01MA12 levofloxacin parenteral formulation 5 mg/ml A
J01CA17 temocillin parenteral formulation 2 g A
J01XA01 vancomycin parenteral formulation 500 mg A
J01CA04 amoxicillin tablets/capsules 750 mg A
J01CE02 phenoxymethylpenicillin tablets/capsules 250 mg A
J01XE01 nitrofurantoin tablets/capsules 5 mg A
J04AC01 isoniazid tablets/capsules 300 mg A
J01FA09 clarithromycin tablets/capsules 250 mg A
J01FA09 clarithromycin tablets/capsules 500 mg A
J01MA12 levofloxacin tablets/capsules 500 mg A
J01MA14 moxifloxacin tablets/capsules 400 mg A
J04AK08 pretomanid tablets/capsules 200 mg A
J04AB02 rifampicin tablets/capsules 150 mg A
J04AB02 rifampicin tablets/capsules 300 mg A
J01EE01 trimethoprim-sulfamethoxazole tablets/capsules 400 mg/80 mg A
D06AX09 mupirocin ointment 2% A
J01CA04 amoxicillin oral solution 50 mg/ml B
J01XX08 linezolid oral solution 20 mg/ml B
J01FA10 azithromycin parenteral formulation 500 mg B
J01DD04 ceftriaxone parenteral formulation 1 g B
J01DC02 cefuroxime parenteral formulation 1,5 g B
J01AA02 doxycycline parenteral formulation 20 mg/ml B
J01DB04 cefazoline parenteral formulation 2 g B
J01GB03 gentamicin parenteral formulation 40 mg/ml B
J01DH56 imipenem-cilastatin-relebactam parenteral formulation 500 mg/500 mg/250 mg B
J01FF01 clindamycin parenteral formulation 600 mg B
J01XB01 colistin parenteral formulation 1 miljon IE B
J01MA14 moxifloxacin parenteral formulation 400 mg/250 ml B
J04AK05 bedakilin tablets/capsules 20 mg B
J01DB05 cefadroxil tablets/capsules 1 g B
J01DB05 cefadroxil tablets/capsules 500 mg B
J01DD08 cefixime tablets/capsules 400 mg B
J01FA01 erythromycin tablets/capsules 250 mg B
J01CE02 phenoxymethylpenicillin tablets/capsules 500 mg B
J01CF05 flucloxacillin tablets/capsules 125 mg B
J01MA12 levofloxacin tablets/capsules 250 mg B
P01AB01 metronidazole tablets/capsules 500 mg B
J01CA08 pivmecillinam tablets/capsules 400 mg B
J04AB04 rifabutin tablets/capsules 150 mg B
J01EA01 trimethoprim tablets/capsules 100 mg B
J01EA01 trimethoprim tablets/capsules 160 mg B
J01GB06 amikacin inhalation 590 mg B
J01DF01 aztreonam inhalation 75 mg B
J01XB01 colistin inhalation 2 miljon IE B
J01MA12 levofloxacin inhalation 240 mg B
D06AX01 fucidin ointment 2% B
J01CE02 phenoxymethylpenicillin oral solution 50 mg/ml C
J01DF01 aztreonam parenteral formulation 2 g C
J01CE01 bensylpenicillin parenteral formulation 0,6 mg C
J01CE01 bensylpenicillin parenteral formulation 1,2 mg C
J01DD01 cefotaxime parenteral formulation 0,5 g C
J01DD01 cefotaxime parenteral formulation 750 mg C
J01DI02 ceftaroline parenteral formulation 600 mg C
J01DD02 ceftazidime parenteral formulation 0,5 g C
J01DD02 ceftazidime parenteral formulation 1 g C
J01DD54 ceftriaxone-lidocaine parenteral formulation 1 g C
J01DC02 cefuroxime parenteral formulation 250 mg C
J01XX09 daptomycin parenteral formulation 500 mg C
J01XX01 fosfomycin parenteral formulation 40 mg/ml C
J01FF01 clindamycin parenteral formulation 300 mg C
J01CF02 cloxacillin parenteral formulation 1 g C
J01XA02 teicoplanin parenteral formulation 200 mg C
J01XA02 teicoplanin parenteral formulation 400 mg C
J01CA17 temocillin parenteral formulation 1 g C
J01GB01 tobramycin parenteral formulation 40 mg/ml C
J01CA04 amoxicillin tablets/capsules 500 mg C
J01MA02 ciprofloxacin tablets/capsules 250 mg C
J04AK06 delamanid tablets/capsules 25 mg C
J04AK06 delamanid tablets/capsules 50 mg C
J01AA02 doxycycline tablets/capsules 40 mg C
J04AM02 rifampicin-isoniazid tablets/capsules 150 mg/75 mg C
J04AM06 rifampicin-isoniazid-pyrazinamide-ethambutol tablets/capsules 150 mg/75 mg/400 mg/275 mg C
J01FA06 roxithromycin tablets/capsules 150 mg C
A07AA09 vancomycin tablets/capsules 250 mg C
J01XB01 colistin inhalation 1 miljon IE C
J01XB01 colistin inhalation 1,66 milj IE C
S02AA15 ciprofloxacin ear- and eye-drops 3 mg/ml C
D10AF01 clindamycin gel 10 mg/ml C
G01AA10 clindamycin vaginal 100 mg C
G01AF01 metronidazole vaginal 7,5 mg/g C
Table 2. Antibiotic products recently deregistered or frequently prescribed on a named-patient basis in Sweden 2021, classified as category A, B or C in the clinical evaluation.
ATC Substance Formulation* Strength Category A-C
J04AB02 rifampicin oral solution 20 mg/ml A
J01DB05 cefadroxil oral solution 100 mg/ml A
J01MA02 ciprofloxacin oral solution 100 mg/ml A
J01FA01 erythromycin oral solution 100 mg/ml A
J04AB02 rifampicin parenteral formulation 600 mg A
J01DD14 ceftibuten tablets/capsules 400 mg A
J04AK02 ethambutol tablets/capsules 400 mg A
J04AK01 pyrazinamide tablets/capsules 500 mg A
J01AA02 doxycycline oral solution 10 mg/ml C
J01CE08 Bensylpenicillin-bensatine parenteral formulation 300000 IE/ml C
J01FF01 clindamycin tablets/capsules 75 mg C
J01AA08 minocycline tablets/capsules 100 mg C
Table 3. Antibiotic products missing at the Swedish market, as proposed by the experts.
ATC Substance Formulation
J01CA08 pivmecillinam oral solution
J01FA09 clarithromycin oral solution
none ceftibuten oral solution
J04AC01 isoniazid oral solution
J01FA09 clarithromycin oral solution
J04AC51 rifampicin/isoniazid tablets/capsules
J04AK02 ethambutol tablets/capsules
J04AC01 isoniazid parenteral formulation
J04AC01 ethambutol parenteral formulation

Updated:

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