Shortage of key syphilis drug raises concerns as congenital cases climb
Shortage of only first-line syphilis treatment for pregnant women impacting Native American babies as congenital infections continue to rise nationwide
The United States is facing a shortage of Bicillin L-A, the only first-line medication recommended for pregnant women with syphilis to prevent transmission to their babies. According to reporting from Source NM, in South Dakota, nearly 90% of congenital syphilis cases reported between 2020 and 2023 involved Native American babies.
The manufacturer, Pfizer, issued a voluntary recall of some lots of the injectable penicillin in July after finding particulate matter in certain batches. The FDA said supplies are not expected to return to normal until December 2027. The agency has allowed temporary imports of Lentocilin from Portugal.
Lack of sufficient treatment and timely testing contributes to 90% of congenital syphilis cases, according to a federal report. Indigenous infants have experienced the highest congenital syphilis rates in recent years, despite representing a much smaller share of the population. Congenital syphilis cases have more than tripled in recent years, with nearly 4,000 cases reported nationwide in 2024, according to the Source NM reporting. Health departments said they are prioritizing available supplies of Bicillin L-A for pregnant patients and newborns affected by the infection.
- 1.Nada Hassanein. Source NM, .
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