STD specialists warn of shortage of vital syphilis drug


As syphilis cases surge across America, a group representing the nation’s STD specialists says members are reporting shortages of a drug essential to fighting the disease.

In a survey from the National Coalition of STD Directors conducted in early November, 46% of sexual health clinics said they’d tried to order Bicillin L-A—only to find that it was unavailable.

Bicillin L-A, a form of penicillin, is crucial to the treatment of syphilis. That’s especially true for congenital syphilis, which occurs when a newborn contracts the illness from an infected mother.

Early in November, the U.S. Centers for Disease Control and Prevention sounded the alarm on the disease, noting that rates of congenital syphilis soared 10-fold between 2012 and 2022.

In 2022, more than 3,700 babies across the United States were born with syphilis, the CDC said.

According to the March of Dimes, “If not treated right away, congenital syphilis can cause problems for your baby later in life,” including deformities of the bones and teeth, paralysis or seizures, problems with vision and hearing and developmental delays.

Luckily, Bicillin L-A can quickly vanquish the syphilis bacterium. It’s the only treatment approved for pregnant women with syphilis, and it’s also the first-line therapy for syphilis patients generally.

Bicillin L-A is made by Pfizer Inc., which in June alerted the U.S. Food and Drug Administration of a shortage that the company predicts may last until mid-2024.

The new survey confirms that Bicillin L-A is in short supply nationwide.

The group sent its survey to 136 state and local health departments and 151 sexual health clinics in early November.

Among the findings:

  • Respondents in 13 different states and one Indian Health Services agency said they’d received reports of at least one pregnant woman who’d been unable to receive Bicillin L-A
  • Nearly half (46%) of clinics said they’d had difficulties getting Bicillin L-A, a increase from the 40% of clinics who hadn’t been able to access the drug when a prior survey was conducted in August
  • More than two-thirds (68%) of health department specialists believe shortages will cause syphilis cases to rise even higher in their jurisdictions

There is a second-line treatment, doxycycline, which patients can use if Bicillin L-A is not available. But treatment can take a month and severe side effects can occur.

In the new survey, 36% of clinics said they’d had a patient who could not complete their full course of doxycycline.

The CDC has already advised that, to preserve supply, doctors use Bicillin L-A only for cases of congenital syphilis and give doxycycline to all other patients.

More information:
Find out more about congenital syphilis from the World Health Organization.

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