Antibiotic shortages expected to worsen syphilis epidemic - NYT

A shortage of penicillin may further hinder attempts to gain control over the syphilis epidemic plaguing the United States, according to an article published by the New York Times on July 7.

Pfizer announced that there would be shortages of Bicillin L-A last month. Bicillin L-A is a long-acting injectable antibiotic that is also known as penicillin G benzathine. 

What is Syphilis?

Syphilis is a sexually transmitted infection (STI). Without treatment, the infection can cause serious life-threatening problems, the UK’s National Health Service (NHS) says. These life-threatening problems include angina, aortic aneurysm, heart failure, seizures, memory problems, personality changes, dementia, nerve pain, joint pain and problems with organs.

According to the NHS, symptoms of syphilis include:

• Small sores (ulcers) on your penis, vagina, or around your bottom (anus) – these are usually painless and you may only have one of them.
• Sores in other areas, including in your mouth or on your lips, hands or bottom.
• White or grey warty growths most commonly on your penis, vagina or around your anus.
• A rash on the palms of your hands and soles of your feet that can sometimes spread all over your body – this is not usually itchy.
• White patches in your mouth.
• Flu-like symptoms, such as a high temperature, headaches and tiredness.
• Swollen glands.
• Patchy hair loss on the head, beard and eyebrows. 

Bicillin is the only treatment for syphilis that is considered safe for pregnant women to take and can help prevent the disease from transferring to the fetus. Without treatment, syphilis increases the risk of miscarriage and birth defects.

“It worries me that these moms may not have access to lifesaving medication,” Dr. Anita Henderson, a pediatrician in Hattiesburg, told the Times.

Why is there an antibiotic shortage?

The shortage, which is expected to worsen the syphilis epidemic, was caused by the very epidemic it is needed for. The rising demand for the medication and amoxicillin has left Pfizer with a shortage. 

Pfizer spokesperson Steven Danehy said that the shortage would likely take a year to rectify, according to the Times. The company will need to increase drug production by 50% to meet the growing demand. 

“Here’s a prime example of why leaving public health to the free market can be disastrous,” Tim Horn, director of medication access at the National Alliance of State and Territorial AIDS Directors, an advocacy group, said in an email to the Times. He added that “Since 2013, the price of Bicillin L-A has increased an astonishing 275 percent.”

The rising syphilis levels 

Syphilis has been on the rise in the United States since 2000, reaching 176,713 cases in 2021, a 75% rise from 2017, according to the Centers for Disease Control and Prevention (CDC).

The CDC has recommended that doctors prioritize offering the drug to infected pregnant women and exposed infants. 

Syphilis rates are highest among infants of Native American, Native Hawaiian, Pacific Islander, and Black mothers, the Times reported. In adult cases of the disease, women carry a fourth of the known cases, while men that have homosexual sex carry just under a third of the known cases. Men who have heterosexual sex exclusively carry one-fifth of the known cases.