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Syphilis treatment guidelines during the Bicillin shortage (2016)

The Public Health Agency of Canada has issued interim syphilis treatment guidelines to be used during the current Benzathine Penicillin G (Bicillin L-A) shortage.  These guidelines are available in PDF format for download under the Additional Resources section below.

These interim guidelines have also been posted in Chapter 5 of the BCCDC Communicable Disease Manual. Please note that the treatment under these guidelines varies from the BCCDC Non-certified practice Syphilis DST (also located in Chapter 5 BCCDC CD Manual) in terms of clients who are prioritized to receive Bicillin and those who are recommended for alternate (doxycycline) therapy.

The BCCDC is encouraging clinicians who are able to provide an order for syphilis treatment to follow the interim guidelines to ensure we are able to prioritize those who need Bicillin most.

While diagnosis and treatment for syphilis infection is not within the scope of STI RN(C) practice, providing treatment for a client who is a contact to a syphilis case is within STI RN(C) scope. If this is part of your practice, please read the following message posted on the CRNBC website in relation to the Treatment of STI Contacts DST and contacts to syphilis:


Please also note: the interim recommendations for contacts indicate treatment with doxycycline for the majority of clients. This aligns with the alternate treatment outlined in the CRNBC Treatment of STI Contacts DST. Please use the alternate treatment during this shortage as much as possible and according to the interim recommendations. Once the shortage is resolved, the BCCDC will provide another provincial communication to alert health care practitioners and the use of standard treatment guidelines can resume.