Nov. 15, 2024
Bicillin L-A, penicillin G benzathine injectable, is the recommended first-line treatment for syphilis, according to the Centers for Disease Control and Prevention. Earlier this year the supply of Bicillin L-A products was limited. The Food and Drug Administration now reports both the 2.4 million units/4 milliliter of Bicillin L-A and 1.2 million units/2 milliliter of Bicillin L-A formulations are available.
As Montana continues to experience a syphilis and congenital syphilis outbreak, the Montana Department of Public Health and Human Services recommends providers:
- Continue to monitor the local supply of Bicillin L-A
- Order a sufficient supply of Bicillin L-A to treat all appropriate patients diagnosed with syphilis and their contacts, per CDC’s standard guidance.
- Email DPHHS if you are unable to order enough Bicillin L-A.
- If you do not have sufficient supply, have contacted DPHHS and are awaiting assistance, prioritize using Bicillin L-A to treat pregnant women with syphilis and babies with congenital syphilis.
- Appropriately stage syphilis to ensure appropriate use of antimicrobials, as early syphilis (primary, secondary and early latent) only requires 2.4 million units of Bicillin L-A.
Reminders from DPHHS on appropriate staging:
- A physical exam is necessary to accurately stage syphilis. Primary lesions are often hidden inside the mouth, anus, or vagina. Signs of secondary syphilis, such as rash, mucous patches, or condyloma lata, may be found on the skin, mouth, or anogenital area.
- Historical syphilis serologic test results can assist with staging if there is evidence of a new infection within 12 months of the previous result.
- Reviewing symptoms and sexual partner history from the past 12 months can help determine the likelihood of early syphilis, i.e. acquisition within the last 12 months.
Please email Kristi Aklestad of DPHHS for more information.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material, is not a guarantee that the service or treatment is a covered benefit and members should refer to their member guide or member contract for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
The information in this article is courtesy of the Montana Department of Public Health and Human Services.