Penicillin G Benzathine (Bicillin L-A) Shortage

DSHS estimates the ongoing shortage of penicillin G benzathine (Bicillin L-A) to last until at least the fourth quarter of 2024. This limited supply poses significant challenges to treating various infectious diseases, especially congenital syphilis. Bicillin L-A is the only treatment option for syphilis for women infected or exposed during pregnancy. Thus, healthcare providers should prioritize Bicillin L-A to protect babies exposed to syphilis in utero.
 

Recommendations for Healthcare Providers

1. Conservation of Bicillin L-A: Given the shortage, DSHS advises healthcare providers to optimize the use of Bicillin L-A by reserving it for pregnant women with syphilis infection or exposure and for infants exposed to syphilis in utero. To treat other conditions, follow alternative regimens during the shortage.
    
2. Communication with Patients: Proactively communicate with patients about the shortage and provide clear guidance on the available treatment options. Explain any modifications or adjustments to their treatment plan to ensure patient understanding and compliance. Providers should perform follow-up clinical and serologic evaluations after treatment at the recommended intervals per the 2021 CDC STD Treatment Guidelines.
    
3. Reporting Adverse Events: Healthcare providers are reminded of their responsibility to report adverse events related to the Bicillin L-A shortage or alternative treatments to their local health department. This information will aid in monitoring the ongoing effect of the shortage and developing appropriate response strategies. 
    
4. Collaboration within Healthcare Networks: Collaborate and share information on the availability of Bicillin L-A, alternative treatment options, and best practices with other healthcare providers and organizations in your network. This collaboration will enhance the understanding and management of the shortage situation.
    
5. Stay Updated: Stay informed about any updates or changes to the Bicillin L-A shortage through reliable sources such as the DSHS website, FDA, CDC, local public health departments, and professional healthcare associations. Regularly check for new information and promptly disseminate updates to your healthcare team. 
    

DSHS Syphilis Resources

• Syphilis
• Congenital Syphilis
• A Call to Action: Rising Rates of Congenital Syphilis in Texas
• Congenital Syphilis in Texas
• Congenital Syphilis is on the Rise
• Fetal Infant Morbidity Review Boards
• What You Should Know About Syphilis
   

Additional Resources

• CDC Announcements About the Bicillin L-A Shortage
• FDA Announcements About the Bicillin L-A Shortage
• Clinical Reminders During the Bicillin L-A Shortage (CDC)