The Canadian government is asking doctors to ration anti-syphilis drugs. Supplies are running dry due to what Health Canada says is combination of manufacturing issues and a rise in national STI rates.
According to a report published by the Public Health Agency of Canada (PHAC), doctors are being advised to limit the amount of Bicillin—a powerful antibiotic that is injected intramuscularly to combat infectious bacteria—given to patients with syphilis due to a severe manufacturer's shortage.
The drug is produced and distributed in Canada by pharmaceutical giant Pfizer, and the report notes that the shortage is expected to last until July of this year. PHAC also advises that there are no good treatment alternatives for those who are infected with syphilis—especially for pregnant mothers who can pass the infection onto their children.
Dr. Supriya Sharma, senior medical advisor at Health Canada, says that an increase in syphilis rates across the country combined with a manufacturing problem at Pfizer has caused the shortage, but that the agency is working on getting it resolved. In the meantime, Sharma says it's important that cases are analyzed on an individual basis.
"There really is no other alternative treatment for pregnant women with syphilis," Dr. Sharma told VICE, noting that pregnant mothers can suffer stillbirth, miscarriages, or development issues in children they give birth to while infected.
"It's really important to treat the infection, so it's not transmitted to others, but also, for any individual, it's important it's treated so they don't have any long-term effects, as they can be quite severe."
According to Dr. Sharma, untreated cases of syphilis can disappear into the body and resurface up to decades later. Infected individuals that go untreated can experience damage to their central nervous system and meningitis-like symptoms, which Sharma says can be avoided if treated early.
In Canada, STIs like syphilis and chlamydia have been on the rise since 2001, despite experiencing a sharp decline throughout the 80s and 90s. Syphilis in particular rose 101 percent between 2003 and 2012, with most of the infections happening among men and women in their 20s.
Sharma says that the factors leading to a greater demand for Bicillin are complex, but that a number of outbreaks reported across the country have destabilized the amount of Bicillin typically produced by Pfizer.
"The reason we're seeing a shortage is it's a supply and demand situation," Sharma told VICE. "Normally, we wouldn't be using as much Bicillin."
Going forward, Sharma says that Health Canada is trying to import a shipment of the drug from Australian authorities, and that Pfizer is working on expediting the July 2016 date expected for the new batch.
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