Communications

(Oct. 23, 2026) – This week, the Kansas Department of Health and Environment issued a Health Alert Network notice on the management of syphilis in adults due to the ongoing shortage of Bicillin L-A (benzathine penicillin G).

Pfizer announced on July 10, 2025, a voluntary recall of multiple lots of Bicillin® L-A (1.2 and 2.4 MU doses) due to particulates in the prefilled syringes. In a January 2026 availability update, Pfizer stated that Bicillin L-A prefilled syringes remain on allocation at the wholesaler level.

Because of the ongoing Bicillin L-A shortage, KDHE encourages considering alternative therapies for non-syphilitic infections, such as strep throat and tonsillitis, to preserve the available supply of Bicillin L-A for patients with syphilis. Additionally, the FDA announced it is allowing the temporary importation of Lentocilin because of the ongoing Bicillin L-A shortage.

In its HAN, KDHE provides recommendations and prioritization guidance for the use of Bicillin L-A (benzathine penicillin G) to treat syphilis in pregnancy and to prevent congenital syphilis; and for the use of Lentocilin (benzathine benzylpenicillin tetrahydrate) for syphilis in pregnancy, for partners of pregnant women who have tested positive for syphilis and for females of reproductive age who may become pregnant. KDHE also includes guidance on the use of doxycycline to treat people with syphilis who are not pregnant and do not have contraindications to doxycycline, as oral doxycycline is an acceptable alternative in the nonpregnant population.

See KDHE's Oct. 19 HAN for detailed recommendations on adult syphilis management during the Bicillin L-A shortage.
--Karen Braman