Crucial syphilis medication is facing serious delays.
A leading GP says his clinic is down to its last few doses of Bicillin L-A (benzathine benzylpenicillin) prefilled syringes, with shortages of the syphilis treatment not expected to ease up for months.
The shortage began in 2024 and was initially attributed to manufacturing issues.
The shortage has since been reported by the TGA as being a result of a global increase in demand, and higher strength injection stocks were expected to improve in mid 2024.
According to Pfizer Australia, normal availability should resume by September.
“The TGA has approved importation of overseas benzathine which can be used,” RACGP sexual health medicine chair Dr Sara Whitburn told The Medical Republic.
“There is advice on the TGA webpage and STI guidelines for GPs about managing the benzathine supply issues and syphilis management in general.
“GPs may need to liaise with their local chemist about supply and may need to liaise early with specialists or local hospital pharmacies if supply is difficult in the community.”
The TGA has stated that it understands the impact of the shortage and has reissued the approval to import and supply an alternative overseas-registered product, extencilline benzathine benzylpenicillin 1.2 million unit vial (France), under section 19A of the Therapeutic Goods Act 1989.
The shortage is expected to impact rural and remote communities the most, with a disproportionate effect on remote indigenous communities.
“If we have a national shortage of benzathine penicillin, then we’re kind of going to be scrabbling for doses … often we find that there’s stockpiles at one clinic where they’re not using it,” Sydney GP Dr Brad McKay told TMR.
“We will need to direct them to other clinics where we might go through more doses over the next few months.”
Dr McKay said benzathine penicillin was his preferred treatment for syphilis because it stayed in the body for a longer period of time.
With the shortage ongoing, he said, his clinic may end up using doxycycline to control patient symptoms and then recall patients once adequate stock of benzathine penicillin arrived.
“We find that there’s a growing problem with syphilis, particularly in Indigenous communities in Australia, particularly at the top end.
“This has been an epidemic that’s been happening since 2011, where we haven’t been able to get syphilis under control.
“If there’s a scarcity of doses, then that’s going to make that problem compounded over the next few months.
“There’s lots of questions that we need to ask about Australia’s access to medication and whether we could be producing these, these chemicals more locally to provide that security of supply.”
