Rates of syphilis have been steadily rising in recent years with an alarming spike in the number of cases of congenital syphilis. These infections are passed from to infants during pregnancy or childbirth and can lead to miscarriage, stillbirth, prematurity, low birthweight, or death shortly after birth. Treatment during pregnancy can help both parent and child, but there is a shortage of Bicillin-L-A, the only antibiotic approved for this population.
Syphilis is a bacterial infection that is passed through skin-to-skin contact with infected lesions. If left untreated, syphilis progresses through four stages. While it remains curable with antibiotics, complications that may develop in the later stages cannot be reversed with treatment and may include serious damage to the brain, heart, nervous system. In some cases syphilis can lead to death.
The Impact of a Treatment Shortage
Bicillin L-A, also called penicillin G benzathine, is the preferred treatment for primary and secondary (P&S) syphilis in adults, infants, and children. It is the only approved treatment for syphilis in pregnant patients. Pfizer—currently the only manufacturer of Bicillin L-A—announced a manufacturing delay in June and suggested that it would likely lead to shortages of the drug through 2024.
The National Coalition of STD Directors (NCSD) surveyed more than 100 sexual health clinics in late August. It found that in the three months prior to the survey, 40% of clinics had attempted to order Bicillin L-A only to be told it was not available. In addition, 28% of clinics said they had to get the drug from a nearby clinic or refer the patients elsewhere for treatment.
This is not the first shortage of this important antibiotic in recent years. Shortages that began in 2005 continued for almost five years. Shortages began again in 2017 as cases of congenital syphilis were beginning to surge. Pfizer says the shortage is a result of the increase in demand, but advocacy organizations aren’t satisfied with that explanation. A letter to the White House Drug Shortage Task Force signed by 39 organizations notes: