KDHE Health Alert on Adult Management of Syphilis During the Bicillin L-A® Shortage
(Oct. 23, 2026) – This week, the Kansas Department of Health and Environment issued an alert to the Health Alert Network regarding management of adult syphilis due to the ongoing shortage of Bicillin L-A (benzathine penicillin G).
Pfizer announced on July 10, 2025, a voluntary recall for 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.
Due to the ongoing shortage of Bicillin L-A, KDHE is encouraging alternative therapies be considered for non-syphilitic infections such as strep throat and tonsillitis so the available supply of Bicillin L-A may be preserved for patients with syphilis. Additionally, the FDA announced it is allowing temporary importation of Lentocilin due to the ongoing Bicillin L-A shortage.
In its HAN, KDHE includes recommendations and prioritization guidance for the use of Bicillin L-A (benzathine penicillin G) for the treating syphilis in pregnancy and preventing congenital syphilis; and the use of Lentocilin )benzathine benzylpenicillin tetrahydrate) for syphilis in pregnancy, partners of pregnant women who have tested positive for syphilis, and females of reproductive age who may become pregnancy. 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 the KDHE's KS-HAN Newsflash for more detailed recommendations on the adult management of syphilis during the Bicillin L-A shortage.
--Karen Braman