In December, 2016, the Centers for Disease Control and Prevention, (CDC), notified the Minnesota Department of Health, (MDH), about a shortage of benzathine penicillin G (Bicillin-LA) and penicillin G procaine due to manufacturing delays. CDC is working with the FDA and Pfizer to address this situation.
ALERT This shortage remains ongoing and a resolution is not expected until the end of 2017. MDH has issued the following health advisory which contains additional information and guidance for health care providers. Updated 05/2017
Penicillin G Benzathine Shortage
Penicillin G benzathine (Bicillin L-A®) is the recommended treatment for syphilis and the only recommended treatment for pregnant women infected or exposed to syphilis.
CDC suggests the following:
- Stop using penicillin G benzathine (Bicillin L-A®) for treatment of other infectious diseases (e.g., streptococcal pharyngitis) where other effective antibiotics are available.
- Follow the recommended dosing regimen of 2.4 million units of penicillin G benzathine IM for the treatment of primary, secondary and early latent syphilis (i.e., early syphilis). Additional doses to treat early syphilis do not enhance efficacy, including in patients living with HIV infection.
- Contact your pharmacists/distributors to obtain penicillin G benzathine (Bicillin L-A®), if you do not have product readily available. If product reaches a critical supply level of three weeks or less, contact Pfizer Injectibles at 844-646-4398 and press 3 for Supply Continuity Team.
More information available at CDC's Penicillin G benzathine (Bicillin-LA) Shortage.
Penicillin G Procaine Shortage
Penicillin G procaine is one of the recommended treatments for congenital syphilis and an alternative treatment for neurosyphilis (NS) and ocular syphilis (OS). Penicillin G procaine is currently unavailable.
CDC suggests the following:
- Use recommended options to treat congenital syphilis and neurosyphilis and ocular syphilis.
- Communicate to health care providers and pharmacists in your clinic or organization that penicillin G procaine is unavailable.
More information available at CDC's Procaine Penicillin G Shortage.
Additional Actions and Resources
- Inform the MDH STD program at 651-201-5414 of any local shortages of penicillin.
- More information on congenital syphilis, neuro-syphilis, and ocular syphilis treatment and clinical management can be found in the 2015 STD Treatment Guidelines.
- Direct questions about syphilis clinical management to an infectious disease specialist or the National Network of STD Clinical Prevention Training Centers (NNPTC) STD Clinical Consultation Network.
- FDA Drug Shortages for additional information, including signing up for email alerts.