Some doctors have been forced to ration penicillin amid an alarming syphilis epidemic sweeping the United States.
Cases of sexually transmitted diseases have soared more than 2,000 percent, from 6,862 in 2002 to 203,500 in 2022, and rates nationwide are at their highest level in 70 years.
The situation was worsened last spring by a shortage of a penicillin injection, which is the first line of treatment for STDs.
The shortage, which still continues, has gotten so bad that public health agencies have advised that providers ration the drug and save it for pregnant patients because it is the only syphilis treatment they can safely receive.
This condition can be fatal or cause deformities in babies born to infected mothers.
The two maps show how the rate of syphilis cases has changed in the US since 2013.
The graph above shows the rate per 100,000 people of the total number of syphilis cases recorded in the US since the 1940s. It reveals that they are starting to improve again.
But the rationing comes amid a broader drug shortage in the United States, as large numbers of children have been hospitalized with colds and flu after lockdowns left them more susceptible due to a weakened immune system.
Penicillin is used to treat infections caused by bacteria, such as meningitis, pneumonia, gonorrhea, and syphilis.
In 2021, there were 46.4 million penicillin prescriptions in the US, the equivalent of 127,123 per day.
Rationing it could leave thousands of Americans without treatment for their throat infections, meningitis and other bacterial infections.
Two antibiotics are used to treat syphilis: injectable penicillin and an oral drug called doxycycline.
The World Health Organization strongly recommends that pregnant women do not take doxycycline because it can cause bone and tooth deformities in babies.
Mark Turrentine, a Houston obstetrician and gynecologist, said KFF Health News that began seeing notices about shortages of injectable penicillin in April, coinciding with the difficulty of obtaining the antibiotic amoxicillin.
In 2022, an increase in respiratory illnesses forced pharmacy chains to temporarily limit purchases of fever-reducing medications for children, contributing to shortages of amoxicillin, a chemically modified penicillin antibiotic in tablet form.
Casual relationships and the “explosion” in popularity of dating apps like Hinge and Bumble have been attributed in part to the syphilis epidemic.
Two antibiotics are used to treat syphilis: injectable penicillin and an oral drug called doxycycline.
Congenital syphilis occurs when a mother transmits the disease to her fetus, which can lead to birth defects, miscarriages, and stillbirth.
Some experts also point to a drop in condom use among American men: nearly 30 percent since 2011, according to some studies.
CDC today urged doctors to be vigilant and asking pregnant women about syphilis if it is an effort to stop the crisis.
The agency provided recommendations for syphilis testing, including serological tests, which check for the presence of specific antibodies in the blood.
Pfizer, the maker of Bicillin, a long-acting injectable form of the antibiotic penicillin, cited “significant increases in demand” due to “an increase in syphilis infection rates” as an explanation for the shortage in a June 2023 letter. to the clients.
Erin Fox, associate director of pharmacy at the University of Utah Health System, told KFF that while penicillin is not a new drug, it is complex to produce because many people are allergic to it.
She said: ‘That means no other medicines can be made on that manufacturing line.
“It’s not necessarily efficient… or necessarily profitable.”
Only pharmaceutical giants like Pfizer have the resources to oversee a separate, specialized facility.
In a statement, Pfizer said demand for penicillin shots had increased by about 70 percent.
But for now, Dr. Stephen Miller, a family physician in Chattanooga, Tennessee, said his clinic has been forced to come up with a strategy.
Each penicillin injection can cost hundreds of dollars. It must also be kept cold and expires after 48 months.
The National Coalition of STD Directors said the STD epidemic is “out of control” and Tennessee has been particularly hard hit, with infection rates for the first two stages of syphilis increasing 86 percent between 2017 and 2021.
Syphilis is a bacterial infection that is spread through contact with sores that usually appear around the pubic area or mouth.
Symptoms appear three to four weeks after infection and are often unnoticed or dismissed as mild abrasions or heat rash.
The disease can then enter a second stage, where the sore disappears and is replaced by a rash that can last for weeks.
Without treatment, patients risk the disease spreading to the brain and spinal cord, which can cause complications such as headaches, stroke and meningitis, or inflammation of the brain’s protective walls.
Congenital syphilis occurs when a mother transmits the disease to her fetus, which can lead to birth defects, miscarriages, and stillbirth.
Nationwide, there were 3,755 cases of congenital syphilis in 2022, a 10-fold increase from a decade earlier.
From 2018 to 2022, cases in infants grew 183 percent. A CDC report from November attributed the increase to a lack of “adequate treatment during pregnancy.”
Doctors use penicillin as a substitute, he said, which may have partly caused the shortage.
Meanwhile, a report last month warned that one in five Americans has been hit by crippling drug shortages.
Manufacturing issues, supply chain setbacks and natural disasters have prevented patients from accessing the medical treatment they need, including life-saving medications for cancer, epilepsy and type 2 diabetes.
The ripple effects of the series of supply chain problems that plagued 2022 may still be to blame for the current medical shortages, the report from ValuePenguin.com, LendingTree’s insurance subsidiary, suggested.
The pandemic was also likely a culprit, causing historic declines in the manufacturing industry. Covid has also increased demand for many types of medications and equipment, such as Paxlovid and N95 masks.