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Resources for clinical management during a Bicillin shortage
Updates as of July 2025

• SFDPH Health Alert: Penicillin G Benzathine (Bicillin L-A) Voluntary Recall and Shortage
• Pfizer announces urgent recall of Bicillin L-A and affected lot numbers
• Pfizer Bicillin Supply Update – July 2025
• FDA on Bicillin L-A shortage and availability of Extencilline
• Extencilline Ordering and Administration Instructions
• Pfizer medical request process
• CDC guidance on priority actions following the recall
• CDC STI Treatment Guidelines for Syphilis
• CDPH: Alternative therapies for the treatment of syphilis in non-pregnant adults
• CDPH: Bicillin L-A Request Form

More syphilis resources

For syphilis titer and treatment history: 628-217-6677

San Francisco City Clinic provider line for clinical questions: 628-217-6677

• Eliminating Congenital Syphilis in San Francisco, 2024-2027 Strategic Plan
  
• Updates on Syphilis Epidemiology, Screening and Diagnosis, December 2020 - Video | PowerPoint 
• Reverse Sequence Syphilis Screening: Info for providers
  • Reverse Sequence Syphilis Screening: Memo from ZSFG Clinical Labs, January 2021
  • Reverse Sequence Syphilis Screening FAQs
• Congenital Syphilis Provider Toolkit
  • Syphilis Health Advisory, April 2021
  • Expanded Syphilis Screening Recommendations, CDPH 2020

  • Congenital syphilis clinical pocket card

  • Evaluating patients for primary syphilis

  • Evaluating patients for secondary syphilis

• Patient Materials

  • "That rash or sore might be syphilis" palm card 

  • "That rash or sore might be syphilis" poster

  • "Syphilis is on the Rise: Get Tested" flyer

  • Congenital syphilis FAQ for patients
    • English
    • Spanish