Update 2 Penicillin G Benzathine Shortage, September 6 2023

This health advisory is to provide updates on the ongoing, nationwide shortage of penicillin G benzathine (Bicillin® L-A), first reported on April 26, 2023. Alameda County released a health advisory April 28 on this shortage. Pfizer is the sole supplier of Bicillin® L-A, and currently anticipates that the shortage will not be resolved until quarter 2 of 2024. Alameda County Public Health Department (ACPHD) has not been informed of shortages, but healthcare systems in San Francisco have reported critical shortages of penicillin G benzathine.

Bicillin® L-A is the only acceptable treatment for pregnant people infected with or exposed to syphilis and should be prioritized for babies exposed to syphilis in utero.

Given the ongoing shortages, it is important supplies be used to treat patients for whom there is no alternative regimen or those unable to adhere to a multiday course of oral treatment. Other intramuscular formulations of penicillin (e.g. Bicillin® C-R) are not acceptable alternatives for the treatment of syphilis. Doxycycline is an
acceptable alternative for non-pregnant adults with primary, secondary, or early and late latent syphilis, and for those who have been exposed to a patient with infectious syphilis.

Please see the Health Advisory for detailed information, including actions requested of Healthcare Providers.