The shortage of Pfizer’s Bicillin L-A (benzathine penicillin G injectable suspension) an antibiotic for syphilis and other bacterial infections, is now predicted to last until the end of 2024. 

To address the ongoing shortage, the U.S. Food and Drug Administration is allowing the temporary import of a similar drug, penicillin G benzathine (brand name, Extencilline). Extencilline has been determined to be equivalent to Bicillin L-A and is currently authorized and marketed in other countries.

The California Department of Public Health (CDPH) is recommending the continued prioritization of Bicillin L-A and Extencilline for pregnant people with syphilis and certain infants exposed to syphilis in pregnancy.

CDPH also reminds providers that oral doxycycline is an appropriate alternative treatment for non-pregnant adults with primary, secondary, early/late latent syphilis and syphilis of unknown duration. 

For more information

• FDA Announcement on Availability of Extencilline
• CDPH Provider Alert on Powdered Benzathine Benzylpenicillin (Extencilline®) for the Treatment of Syphilis
• CDC STI Treatment Guidelines