Korean doctors are finding it difficult to treat patients due to the shortage of doxycycline, an antibiotic, industry sources said. A local drugmaker stopped manufacturing doxycycline-containing medicines in November because it could not import raw materials, they said.

Doxycycline is commonly used in urology as the first-line treatment for sexually transmitted diseases and internal medicine as a treatment for scrub typhus. In dermatology, the antibiotic is widely used for inflammation treatment.

To treat syphilis, urologists often use doxycycline instead of benzathine penicillin, which is difficult to obtain. Benzathine penicillin is an orphan drug supplied only through the Korea Orphan & Essential Drug Center (KODC).

A director of a urology clinic in Seoul said several months have passed since the doxycycline supply for sexually transmitted disease treatment has been cut off. “We’ve been using doxycycline that has been stocked up until now. But we don’t have it anymore,” he said.

The director went on to say that when he treated syphilis, he used to administer doxycycline for four weeks if the patient was allergic to benzathine penicillin or who could not get an injection.

However, as benzathine penicillin is a rare drug, a doctor should make a phone call to KODC to purchase it. Thus, he preferred doxycycline to benzathine penicillin, he said.

Lee Jong-jin, president of the Association of Korean Urologists, said clinicians would be in big trouble if all doxycycline antibiotics go out of stock. “As far as I know, some products are still available at pharmacies,” he said. What worried him was that the supply of raw materials for doxycycline was going short.

Lee said he had to prescribe another antibiotic because the existing product went unavailable.

The shortage of the doxycycline supply is likely to continue. Industry officials said a chemical plant explosion in Chenjiagang Chemical Industry Park in Xiangshui County of Yancheng in Jiangsu Province led to a burndown of a raw material drug factory in 2019. Since then, the Chinese government has been delaying GMP approval for a renewed plant, they said.

Youngpoong Pharmaceutical said it discontinued the manufacturing of Youngpoong Doxycycline Tab. in November last year. It may resume production in May at the earliest, the company said.

“Raw materials come from China, but the Chemical Industry Park in Yancheng in Jiangsu Province had an explosion, which burned down the raw material factory,” an official at Youngpoong Pharmaceutical said. “To make matters worse, the Chinese government put brakes on the resumption of the plant citing environmental issues, which led to approval delay.”

The official had expected that the factory would win the license in March, but the approval was put off longer than anticipated, he added.

Youngpoong manufactured some of the products with the remaining inventory, but the stock recently ran out, the official said. “We have noticed this situation to the Chinese and Korean government and requested their help. I heard an official at the Ministry of Food and Drug Safety was dispatched to the Chinese site,” he said.

He said he heard that the Chinese plant began pilot production of raw materials recently. The supply of the raw materials may start in mid-May, he added.

Sinil Pharmaceutical also stopped producing Sinil Monodoxy-M Cap., a doxycycline antibiotic, last year.

Medica Korea reduced the quantity of Bydoxy Tab. due to the shortage of raw materials.

“The supply of the raw materials is insufficient. It is because of the Chinese government’s delay of GMP certification rather than the repercussions of the plant explosion,” a pharmaceutical industry executive said. “It is an international issue, so urging China does not accelerate the supply. I don’t know when we can supply our product, either.”