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MDH Notice to Health Care Providers: Penicillin Shortage December 2016
Situation: MDH was recently notified by CDC about difficulties in obtaining benzathine
penicillin G ( Bicillin-LA) and penicillin G procaine. Pfizer, the sole manufacturer in the United
States, continues to experience a manufacturing delay of these products. CDC is working with FDA’s
Drug Shortage Staff and Pfizer to address this situation. Additional information on the availability of
these drugs can be found at https://www.cdc.gov/std/treatment/drugnotices/bicillinshortage.htm and
the FDA’s Drug Shortage Website.
Procaine Penicillin G Shortage
Penicillin G procaine is one of the recommended treatments for congenital syphilis and an
alternative treatment for both neurosyphilis (NS) and ocular syphilis (OS).
Penicillin G procaine is currently unavailable and Pfizer’s current estimate is that product is not
expected to begin to be available until April 2017. Until Penicillin G procaine is available, CDC
suggests the following:
1. Use recommended options to treat congenital syphilis and neuro-syphilis or ocular syphilis.
2. Communicate to healthcare providers and pharmacists in your clinic or organization that
penicillin G procaine is currently unavailable so they are aware and can plan. Pfizer’s
current estimate for penicillin G procaine is that it will not be available until April 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. Until normal quantities
of penicillin G benzathine (Bicillin L-A®) are available, CDC suggests the following:
1. Refrain from the use of penicillin G benzathine (Bicillin L-A®) for treatment of other infectious
diseases (e.g., streptococcal pharyngitis) where other effective antimicrobials are available.
2. Adhere to 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) as outlined in the
2015 STD Treatment Guidelines (see link below). Additional doses to treat early syphilis do not
enhance efficacy, including in patients living with HIV infection.
3. Contact your pharmacists/distributors to procure 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 at 800-533-4535 for assistance.
ADDITIONALLY: Alert the STD, HIV and TB Section at MDH at 651-201-5414 of any shortages
as they are keeping CDC informed.
More information on congenital syphilis, neuro-syphilis, and ocular syphilis treatment and clinical
management can be found in the 2015 STD Treatment Guidelines
(https://www.cdc.gov/std/tg2015/syphilis.htm). CDC is not recommending any changes to these
treatment recommendations for patients with congenital syphilis, neuro-syphilis, and ocular syphilis.
Direct specific questions about syphilis clinical management to an infectious disease specialist or the
on-line National Network of STD Clinical Prevention Training Centers (NNPTC) STD Clinical
Consultation Network (https://www.stdccn.org ).