Communications

(Dec. 19, 2025) – Penicillin G benzathine injectable suspension (Bicillin-LA) remains in short supply following Pfizer's July 2025 voluntary recall of certain lots because of particles identified during visual inspection. In a Dec. 10, 2025, update, the American Society of Health System Pharmacists Drug Shortages notes that Pfizer attributes the Bicillin-LA shortage to increased demand. According to ASHP's drug shortages site, Pfizer is allocating resources to manufacturing adult Bicillin-LA presentations because of increased syphilis infection rates. Once current supplies of pediatric Bicillin-LA vials are depleted, it is unclear when additional product will be manufactured. It appears that Pfizer's Aug. 21, 2025, Bicillin-LA Availability Update is the most recent issued by Pfizer.

As a result of the continued shortage, the Kansas Department of Health and Environment issued a HAN on Dec. 15 regarding the agency's inability to maintain a sufficient supply of penicillin G benzathine to meet demand and encouraging providers who treat sexually transmitted infections to continue following the CDC Treatment Recommendations for Syphilis. Penicillin G benzathine (Bicillin LA) is the only recommended treatment for pregnant people infected with or exposed to syphilis. Its use for pregnant people and babies with congenital syphilis should be prioritized and considered for individuals who are HIV-positive. In its HAN, KDHE encourages providers to prioritize doxycycline for people infected with or exposed to syphilis who are not currently pregnant, as outlined in the CDC Dear Colleague Letter posted after the Bicillin LA recall.
--Karen Braman