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June 8, 2023
Pfizer pharmaceuticals has reported a shortage of benzathine penicillin (Bicillin LA) due to increased demand for the drug related to the growing national and international epidemic of syphilis. Pfizer is the sole supplier of benzathine penicillin in the U.S. Local medical providers have alerted local public health that they have had trouble securing benzathine penicillin to treat patients with syphilis. In the face of this shortage, public health is asking medical providers to treat selected patients with syphilis with doxycycline if they believe that the patient can adhere to a recommended course of treatment. Additionally, because it is often difficult to assure that patients with late latent syphilis or syphilis of unknown duration receive three injections of benzathine penicillin at weekly intervals, medical providers should consider treating such patients with a regimen that combines a single intramuscular dose of benzathine penicillin with a 28-day course of doxycycline. The decision to use such a regimen should be made in collaboration with the patient receiving the treatment.