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Provider Alert - Dosing Guidelines for National Shortage of Penicillin G Benzathine (Bicillin L-A)
May 31, 2023
Prioritizing medication supply for pregnant women
A previous version of this provider alert was distributed with an error in the dosing guidelines. Please disregard the previous version, and utilize the information below.
Tallahassee, Fla. — The Florida Department of Health (Department) has been monitoring the national shortage of Penicillin G benzathine injectable suspension (Bicillin® L-A), which is the primary treatment for syphilis. To ensure efficient use of this medication during the national shortage, the Department is providing health care providers with dosing guidelines for patients with syphilis.
Health care providers should prioritize this medication supply for pregnant women. This medication is the only acceptable option for pregnant women with, or exposed to, syphilis. During this drug shortage, all other syphilis patients (male and non-pregnant females) should be receiving doxycycline 100mg po BID in the absence of contraindications for either 14 or 28 days, depending on their stage of infection.
Dosing guidelines for pregnant women can be found below:
- Primary and Secondary Syphilis: Benzathine penicillin G 2.4 million units IM in a single dose
- Early Latent Syphilis (less than one year): Benzathine penicillin G 2.4 million units IM in a single dose
- Late Latent Syphilis or Latent Syphilis of Unknown Duration: Benzathine penicillin G 2.4 million units IM x 3 doses, each at 1–week intervals
If there are additional questions regarding treatment or staging of a particular patient, please contact the Florida Department of Health.
If you do not have access to Penicillin G benzathine injectable suspension in your practice, please refer your pregnant women with syphilis to your county health department for treatment.
The Department is reviewing alternative treatments for pregnant women with syphilis and will continue to notify providers of any updates. More information on congenital syphilis can be found here.
About the Florida Department of Health
The department, nationally accredited by the Public Health Accreditation Board, works to protect, promote and improve the health of all people in Florida through integrated state, county and community efforts.