There is currently a shortage of Bicillin L-A, a type of penicillin used to treat syphilis, which is causing concern among infectious disease experts. The shortage was announced by drugmaker Pfizer last month due to increased demand caused by rising rates of syphilis infections. The drug is also being used as an alternative to amoxicillin, another antibiotic that has been in short supply. Pfizer anticipates it will take about a year to increase production by 50% and meet demand.
Syphilis cases in the US have been on the rise since 2000, reaching 176,713 in 2021, an increase of nearly 75% since 2017. Congenital syphilis, which affects infants, has tripled during this period. Bicillin is the recommended treatment for pregnant women with syphilis and is effective in preventing transmission to the fetus. Without access to this medication, there is a risk of preterm birth, severe birth defects, and even death for the infants.
The shortage of Bicillin is also impacting other areas of healthcare. Pfizer has warned that a pediatric version of the drug will soon run out as the production line is being used to increase production of the adult formula. Bicillin is used to manage rheumatic heart disease and rheumatic fever, conditions that pose health risks for children. Alternative antibiotics are available for these conditions, but they are years away from being accessible.
The shortage of Bicillin is part of a larger drug-shortage crisis that has affected various essential medications. Doctors and pharmacists are struggling to secure therapeutic staples, leading to rationing of treatments like chemotherapy. A recent Senate report also highlighted the supply problems as a threat to national security.
Antibiotics have traditionally had lower profit margins compared to blockbuster drugs, which has resulted in a lack of interest from pharmaceutical companies in developing new antibiotics. Legislation like the Pasteur Act, which offers a subscription model for research and development, aims to incentivize pharmaceutical companies to address drug shortages and combat drug-resistant pathogens.
Critics argue that Pfizer’s inadequate production of Bicillin is concerning given the long-term increase in syphilis infections. The Biden administration is also facing criticism for reducing the budget for STI prevention at the CDC. To ensure the limited supply of Bicillin is used effectively, the CDC recommends prioritizing pregnant patients and infected infants. Other patients may be prescribed doxycycline, but there are concerns about adherence to the twice-daily pill regimen.
Experts have raised concerns about Pfizer’s pricing practices, highlighting the significant price increase of Bicillin in recent years. The cost of the antibiotic has become a burden for independent clinics, with prices rising from $4,000 to $6,500 for a 10-pack of shots.
In summary, the shortage of Bicillin L-A is causing alarm among infectious disease experts due to the increasing rates of syphilis and limited treatment options for pregnant women and infants. The shortage is part of a wider drug-shortage crisis, and there are concerns about Pfizer’s production and pricing practices. Efforts are underway to develop alternative treatments and incentivize pharmaceutical companies to address these challenges.
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