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Update on sexually transmitted infections in BC: June 2016

Please circulate these key STI updates to your networks.

Benzathine penicillin (Bicillin L-A) is once again available in Canada

Several months ago, Pfizer Canada – the sole Canadian manufacturer of Bicillin L-A – announced that it would be temporarily ceasing production of this drug. As a result, interim guidelines for the treatment of syphilis were produced by the STI Expert Working Group of the Public Health Agency of Canada, with the goal of ensuring an adequate supply of Bicillin L-A for those requiring it during the shortage. In the intervening months, a supplemental supply was also secured from Pfizer Australia; however, given the uncertainty of the timeline for the shortage, the decision was made to carry on with the interim treatment guidelines. 

Currently, we have confirmed with Pfizer Canada that their production is back to normal, and there should not be any concerns with supply going forward. You should resume use of Bicillin L-A for the treatment of syphilis. Please disregard the interim treatment guidelines for syphilis, and resume using the “British Columbia Treatment Guidelines:  Sexually Transmitted Infections in Adolescents and Adults, 2014”.

Provincial increase in all STIs

Though we typically see year-to-year increases in STI rates in BC, 2015 demonstrated a particularly marked increase in bacterial STIs compared to 2014. Some of the trends noted in 2015 include:

  • A 75% increase in cases of gonorrhea;
  • A 40% increase in syphilis, representing the highest rates we have seen in 30 years;
  • Cases of lymphogranuloma venereum (LGV), a particular serovar of Chlamydia trachomatis causing syndromes with symptoms varying from ulcers to hemorrhagic proctitis, were the highest ever recorded in BC, with over 40 cases.

In 2016, we are continuing to see additional increases in many of these infections.

For any questions about these updates, please contact the STI clinical team at 604-707-5603.