In this episode, I’ll discuss how to obtain penicillin G benzathine during a national shortage.
Due to increased demand, there is currently a shortage of long-acting penicillin G benzathine injectable suspension products. Pfizer is the sole penicillin G benzathine injection manufacturer for the US market. This is not the first time the US has dealt with a shortage of this product as back in 2017 there was a nationwide shortage due to manufacturing delays.
While parenteral penicillin G is the preferred drug for treating patients in all stages of syphilis, the CDC does have recommendations for the use of doxycycline for non-pregnant patients during this shortage. Unfortunately, penicillin G is the only recommended treatment for pregnant women with syphilis and babies with congenital syphilis. While supplies are supposed to be reserved and prioritized for these populations during the shortage, there is very real chance hospitals could run out and then have a patient that requires penicillin G benzathine present for treatment.
There are several resources available to help if this scenario arises during the shortage. In a “Dear Customer” letter from Pfizer, the manufacturer provides a phone number for their supply continuity team as well as a website with frequently updated product availability reports. The CDC has also published clinical reminders for healthcare providers during the shortage.
The current guidance in the Pfizer document states:
Limited inventory released direct and to wholesalers/distributors in part or full when available. Inventory may not cover market demand. Please inquire with wholesalers/distributors directly regarding their availability, call your Pfizer Hospital representative.
Even if you are not able to obtain product through these means, all hope may not be lost. Thankfully, because providing treatment to curb the spread of syphilis within the community is a fundamental public health duty, the health department of most states can be called upon to facilitate the recommended treatment for syphilis in the setting of the shortage. Therefore, if you are having difficulty obtaining Bicillin L-A for a patient who needs it using your typical resources and the number from Pfizer’s “Dear Customer” letter, pharmacists should be able to contact their local health department to get the necessary product available to treat their patient.
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