Injection penicillin recalls pose potential threats to syphilis progress
In recent news, Pfizer, the sole supplier of Bicillin L-A, a crucial drug used for treating syphilis in pregnancy, has announced a delivery of pediatric doses expected in October [1]. However, the drug has been in shortage since 2023, leaving healthcare providers scrambling for alternatives.
Bicillin L-A is essential because it reliably crosses the placenta, treating both the pregnant person and the fetus, thereby preventing congenital syphilis [3]. There is no equally effective alternative to penicillin for pregnant individuals; doxycycline and other non-penicillin antibiotics are contraindicated in pregnancy due to safety concerns for the fetus [2].
During shortages, public health authorities emphasize strict prioritization of remaining supplies for the highest-risk groups, including pregnant individuals, babies with congenital syphilis, and sexual partners of pregnant individuals [2]. Doxycycline, which is sometimes used in non-pregnant adults for early syphilis (not recommended for late latent syphilis), is not a safe or acceptable alternative during pregnancy due to its association with fetal harm [2].
If Bicillin L-A is truly unavailable, there is no recommended alternative antibiotic for treating syphilis in pregnancy. In such rare, critical situations, consultation with a maternal-fetal medicine specialist, infectious disease expert, and public health authority is essential to explore all possible options [2].
A summary table outlines the treatment options for syphilis in pregnancy:
| Patient Population | Treatment of Choice | Alternative Options | Notes | |----------------------|-------------------------|--------------------|------------------------------------------------------------| | Pregnant individuals | Penicillin (Bicillin L-A)| None (consult ID/MFM) | Doxycycline contraindicated; no safe, effective alternative[2] | | Non-pregnant adults | Penicillin | Doxycycline | Doxycycline not for late latent syphilis[2] |
Pfizer has advised customers that it will provide an update on the Bicillin supply no later than mid-August [1]. Until stock has fully recovered, Pfizer will ration available supplies of the shots, and providers will have to fill out medical request forms to receive them [1].
The National Coalition of STD Directors is gathering information from its members to understand the impact of the Bicillin recall [4]. There are concerns that cuts to funding for national and local STD programs may lead to a drop in testing for syphilis [5]. The CDC had previously posted recommendations for caring for syphilis patients during the shortage, but this information has since been taken down [5].
The US Department of Health and Human Services has referred questions about the recall and potential supply problems to Pfizer [6]. The University of Utah Health's hospital system finds it difficult to use imported products due to unrecognized bar coding and differences in product mixing and dilution [7]. One state returned about 800 vials of Bicillin to Pfizer, indicating a widespread impact of the recall [8].
Healthcare providers are managing the Bicillin shortage by being selective about who receives Bicillin shots and have not had to use imported products yet [9]. The hospital system emphasizes the importance of strict prioritization of remaining supplies for the highest-risk groups [2].
In conclusion, during the Bicillin L-A shortage, penicillin remains the only acceptable treatment for syphilis in pregnancy. Healthcare providers must prioritize penicillin for pregnant patients and work closely with public health and specialty services to secure supplies. In rare cases where access is severely limited, consultation with experts is critical.
- The health industry has been looking into various aspects of science, including sleep, workplace-wellness, medical-conditions, and fisher's announcement of pediatric doses for Bicillin L-A in October.
- Bicillin L-A is an essential drug for treating syphilis in pregnancy, as it effectively affects both the pregnant person and the fetus.
- A lack of equally effective alternatives to penicillin for pregnant individuals has been a concern, as doxycycline and other non-penicillin antibiotics are contraindicated due to safety concerns for the fetus.
- During shortages, public health authorities advise strict prioritization of supplies for the highest-risk groups, such as pregnant individuals and babies with congenital syphilis.
- Doxycycline, while sometimes used in non-pregnant adults for early syphilis, is not generally recommended for use during pregnancy due to its association with fetal harm.
- If Bicillin L-A is unavailable, there is no recommended alternative antibiotic for treating syphilis in pregnancy, making consultations with maternal-fetal medicine specialists and public health authorities essential.
- A summary table outlines the treatment options for syphilis in pregnancy, recommending penicillin as the treatment of choice with no safe, effective alternative during pregnancy.
- Pfizer has advised customers that it will provide an update on the Bicillin supply by mid-August and has plans to ration the shots during the shortage.
- The National Coalition of STD Directors is collecting data to understand the impact of the Bicillin recall, and there are concerns about potential funding cuts for national and local STD programs.
- The CDC previously posted recommendations for caring for syphilis patients during the shortage, but this information has since been removed.
- The US Department of Health and Human Services has referred questions about the recall and potential supply problems to Pfizer.
- The University of Utah Health's hospital system encounters difficulties using imported products due to unrecognized bar coding and differences in product mixing and dilution.
- Some states have returned vials of Bicillin to Pfizer due to the widespread impact of the recall.
- Healthcare providers are managing the Bicillin shortage by being selective about who receives Bicillin shots and are not yet using imported products.
- The hospital system emphasizes the importance of strictly prioritizing remaining supplies for the highest-risk groups.
- Climate change and its potential effects on health and wellness are an important area of study in environmental science.
- Mental health, a growing concern in personal and public health, is impacted by a wide range of chronic diseases, such as cancers and respiratory conditions.
- Fitness and exercise are essential components of men's health and have been shown to reduce the risk of various cardiovascular health issues.
- Eye health is crucial for overall wellness, and certain medical conditions like diabetes can lead to complications in this area.
- Hearing loss and its prevention are becoming key topics in the health and wellness industry, with research focusing on therapies and treatments for different types of hearing disorders.
- Free resources for improving sexual health, such as educational materials and screenings, are often available through organizations committed to health and wellness.
- Nutrition and weight management are closely connected, as a balanced diet can help maintain a healthy weight and reduce the risk of autoimmune disorders.
- Aging brings on various issues related to digestive health, making it essential to maintain a healthy gut and practice proper skincare to minimize age-related changes.
- Women's health encompasses numerous aspects, from reproductive care to menopause management; it is important for individuals to be well-informed and take charge of their health.
- Parenting involves making decisions regarding a child's health and wellbeing, so furthering one's knowledge in areas like pediatric nutrition and child development is crucial.
- Medical cannabis (CBD) can be beneficial for managing certain medical conditions, like anxiety and pain, but its effects and legality vary depending on jurisdiction and personal health circumstances.
- Neurological disorders like Alzheimer's and Parkinson's have far-reaching impacts on individuals and their families, making investments in neurological research and care a priority in fiscal planning.
- Overall lifestyle, including factors like diet, exercise, and sleep habits, can have a significant impact on mental health and quality of life in aging adults.
