Bicillin L-A®
Adequately treating syphilis in pregnancy and reducing congenital syphilis cases is challenged by intermittent shortages of benzathine penicillin G (Bicillin L-A®). The FDA currently lists Penicillin G benzathine injectable suspension products (Bicillin L-A®) on its drug shortage webpage where updates on shortages and drug availability can be found.
The CDC offers a series of clinical reminders during the Bicillin L-A® shortage emphasizing the critical need to prioritize using Bicillin L-A® to treat pregnant people with syphilis and babies with congenital syphilis, as penicillin is the only recommended treatment for these populations.
The Illinois Department of Public Health offers guidance for Illinois providers through it's SIREN (State of Illinois Rapid Electronic Notification) system which most recently published a health alert for the Bicillin recall on July 17, 2025.
Extencilline
To address the ongoing shortages of Bicillin L-A®, the U.S. Food and Drug Administration (FDA) announced the availability of Extencilline (benzathine benzylpenicillin injection, powder, for suspension). The FDA has exercised enforcement discretion for a temporary importation and use of this treatment to mitigate the effects of the Bicillin L-A® drug shortage. Extencilline has been determined to be equivalent to Bicillin L-A® and is currently authorized and marketed in other countries.
See the Illinois Department of Public Health's information regarding acquisition and use of Extencilline.
This page last updated 8/28/25