Surge in syphilis cases drives some doctors to ration penicillin

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The drug is the go-to treatment for syphilis and the only one recommended for pregnant people. But a shortage of the injectable drug has prompted some public health agencies to ration it.

Vials of injectable penicillin in cold storage at the Metro Public Health Department in Nashville, Tenn. Injectable penicillin is the go-to treatment for syphilis and the only treatment considered safe for pregnant people with the disease.Vials of injectable penicillin in cold storage at the Metro Public Health Department in Nashville, Tenn. Injectable penicillin is the go-to treatment for syphilis and the only treatment considered safe for pregnant people with the disease.

Hamilton County's syphilis rates have mirrored the national trend, with an increase in cases for all groups, including infants.. It found that, nationwide, about 15.5% of pregnant people received care beginning in the fifth month of pregnancy or later — or attended fewer than half the recommended prenatal visits. In Tennessee, the rate was even worse, 17.4%.

"What we found is, a lot of times their partner was not as monogamous, and they were bringing it into the relationship," Miller said. As a result, pregnant syphilis patients are often given penicillin, even when they're allergic, using a technique called desensitization, said Mark Turrentine, a Houston OB-GYN. Patients are given low doses in a hospital setting to help their bodies get used to the drug and to check for a severe reaction. The penicillin shot is a one-and-done technique, unlike an antibiotic, which requires sticking to a two-week regimen.

Even though penicillin has been around a long time, manufacturing it is difficult, largely because so many people are allergic, said Erin Fox, associate chief pharmacy officer for the University of Utah health system and an adjunct professor at the university, who studies drug shortages. "This ramp up will take some time to be felt in the market, as product cycle time is 3-6 months from when product is manufactured to when it is available to be released to customers," the statement reads. The company estimated the shortage would be significantly alleviated by spring.

 

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