Pfizer, the manufacturer of Bicillin – a long-acting injectable form of the antibiotic penicillin – is warning doctors that it expects to run out of its formulations for children by the end of June. Formulations for adults are also expected to be in short supply but are not expected to run out.
The company sent a letter to clinicians this week, which was posted by the US Food and Drug Administration.
Bicillin is one antibiotic in a range of options that doctors can use to treat common childhood infections. Pfizer says it is not widely used in pediatrics because other options, such as amoxicillin, are preferred for kids.
“This is a long-acting form of penicillin: You can just get one to two shots, and then you’re done, versus taking amoxicillin for five to seven days,” said Erin Fox, a pharmacist at the University of Utah who tracks drug shortages.
Fox says the shots are painful, however, “so nobody likes to use them unless you have to.”
In adults, Bicillin is the recommended treatment for the sexually transmitted infection syphilis.
Pfizer says it is prioritizing the manufacture of its formulation for adults, who don’t have as many alternatives.
Fox says that’s the right move. “The adult formulation of Bicillin L-A is the most important, as that is the only product available to treat pregnant patients with syphilis,” she said.
Syphilis can be passed from mother to baby in the womb. Up to half of babies infected this way die shortly before or after birth. Even if a baby survives, they may face lifelong consequences from their infections including blindness or deafness.
Rates of syphilis have been steadily increasing, rising more than 30% in 2021 in adults, according to the US Centers for Disease Control and Prevention, putting additional pressure on limited supplies of the treatment.
Pfizer says supplies were strained over the fall and winter when the antibiotic amoxicillin went into shortage and doctors began using Bicillin as a recommended alternative.
The company says it is working to increase supplies of Bicillin but can’t ramp up production as quickly as it would like to because of how tightly the manufacture of antibiotics is regulated and how complicated the products are to make.
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The US Food and Drug Administration said in a statement that it “recognizes the potential impact that lack of availability of certain products may have on health care providers and patients.”
“While the agency does not manufacture drugs and cannot require a pharmaceutical company to make a drug, make more of a drug, or change the distribution of a drug, the public should rest assured the FDA is working closely with numerous manufacturers and others in the supply chain to understand, mitigate and prevent or reduce the impact of intermittent or reduced availability of certain products,” the FDA said.