23-643m Prioritize Bicillin® L-A to Treat Syphilis in Pregnant Persons Until Q4 2023

Date: 06/29/23

Prescribe alternate drug doxycycline to treat syphilis in non-pregnant persons

An increase in syphilis infection, including in pregnant persons and congenital syphilis in infants, created a higher demand for long-acting Bicillin (benzathine penicillin G).

The California Department of Public Health (CDPH) STD Control Branch (STDCB) issued a health advisory on June 1, 2023 about the Bicillin L-A shortage due to the increase in demand. The advisory follows the guidelines from the Centers for Disease Control and Prevention (CDC).

The Bicillin L-A drug shortage is expected to last until fourth quarter (Q4) 2023. You can monitor the shortage on the U.S. Food and Drug Administration (FDA) webpage.

Prioritize treatment of syphilis in pregnant persons

CHPH STDCB recommends the following when prioritizing treatment with Bicillin L-A:

• Pregnant people infected with or exposed to syphilis – Bicillin L-A is the only recommended treatment.
• Infants exposed to syphilis in utero – Timely treatment with Bicillin L-A is almost 100% effective at preventing bad outcomes of congenital syphilis in infants.
• Persons with contraindications to doxycycline (e.g., anaphylaxis, hemolytic anemia, Stevens Johnson syndrome).

Treat syphilis with doxycycline for non-pregnant adults

Follow the recommended use and dosage of doxycycline as an acceptable alternative.

The dosage of doxycycline is 100 mg orally twice per day for people with:

• Primary, secondary, or early latent syphilis – taken for 14 days.
• Late latent syphilis or syphilis of unknown duration – taken for 28 days.

Note: Use of other intramuscular formulations of penicillin, including Bicillin C-R, are not acceptable alternatives for the treatment of syphilis.

Questions or help with Bicillin L-A

For issues with shortages or obtaining Bicillin L-A medication, contact your local health department.

For clinical questions related to the treatment of syphilis during the Bicillin L-A shortage, please contact the STD Clinical Consultation Network, your local health department, or CDPH STDCB by phone at 510-620-3400 or by email.

Additional information

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by telephone or through the Health Net provider portal.

Line of business	Phone number	Email address
IFP Ambetter PPO	844-463-8188	provider_services@healthnet.com
IFP Ambetter HMO	888-926-2164	provider_services@healthnet.com
Health Net Employer Group HMO, POS, HSP, PPO, & EPO	800-641-7761	provider_services@healthnet.com
Medicare (Individual & Employer Group)	800-929-9224	provider_services@healthnet.com
Medi-Cal	800-675-6110	N/A

 

This information applies to Physicians, Participating Physician Groups (PPGs), and Hospitals.

For Medi-Cal, This information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.