ACCHOs continue to lead the way in managing ARF, RHD, and syphilis in Aboriginal and Torres Strait Islander communities, and are critical in ensuring continuity of care despite supply challenges in benzathine benzylpenicillin. On 24 July Thursday, NSW Health issued a GP Alert due to the ongoing manufacturing shortage for benzathine benzylpenicillin (Bicillin L-A) and the approved S19A alternatives within Australia.
In response to this shortage, recommendations include conserving the above medications to use for:
- treatment of ARF;
- secondary prophylaxis against RHD;
- treatment of group A streptococcal infections among patients where there are concerns about their adherence to oral antibiotics; and
- treatment of syphilis in pregnancy.
There is also a new recommendation that where not contraindicated, oral doxycycline is to be used for the treatment of syphilis in non-pregnant patients and their sexual contacts.
Follow-up of these patients will be required to ensure symptom resolution and serological response as demonstrated by a 4-fold drop in RPR titre within 12 months. Details are outlined in the Australian STI Management Guidelines. Further assistance with managing syphilis in your clinics, is available through the Sexual Health InfoLink (SHIL) on 1800 451 624, Monday-Friday 9am-7pm.
If clinics are unable to access benzathine benzylpenicillin for their ARF/RHD patients, refer to the ARF/RHD Guidelines for alternative management options or contact the NSW ARF/RHD Register on (02) 9391 9195 or NSWH-RHD@health.nsw.gov.au
