Penicillin G Benzathine (Bicillin L-A) Shortage

During a national webinar, CDC’s June 10, 2024 Clinical Reminders during Bicillin L-A® Shortage link was shared:

On June 10, 2024, Pfizer shared an update on their 2.4 million Units/4 milliliter Bicillin L-A® supply, noting that they currently have available supply. If there is sufficient supply of Bicillin L-A ® in your jurisdiction, please consider using Bicillin L-A® for all appropriate patients, per CDC's standard guidance.

If you are experiencing Bicillin L-A® supply issues, please notify DSTDP of any shortages and contact Pfizer Hospital US directly at the number or email below:

Pfizer Hospital US:
Phone: 844-646-4398
Hours: Monday-Friday 7:00 a.m. – 5:00 p.m. CST
Email: PISupplyContinuity@Pfizer.com (For assistance with orders/supply information)

Note Bicillin® L-A supply is improving, but it will not be fully available until later this year, per Pfizer's Availability Report.

Availability of Bicillin L-A® in Texas has not changed, and we continue our conservative approach and guidance and prioritization of usage during the ongoing Bicillin shortage.

The Texas DSHS pharmacy is checking with our distributor on current availability, as they have done since the beginning. We will provide updates when our inventory increases enough to relax conservation measures.

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

Additional Resources

 

HIV/STD Program

HIV/STD Program

Congenital Syphilis