Benzetacil instead of Bicillin – Update for primary care
Due to a global shortage of Bicillin L-A, Te Whatu Ora | Health NZ has issued updated guidance for primary care on transitioning most eligible patients to Benzetacil for rheumatic fever secondary prophylaxis and syphilis treatment. Benzetacil is now available to order through PSO and contains the same active antibiotic as Bicillin.
Update as of 16 July 2026
Te Whatu Ora | Health NZ has provided a further update on the transition from Bicillin L-A to Benzetacil. Early feedback indicates Benzetacil has been well tolerated by patients. Practices should continue transitioning young people and adults to Benzetacil, reserve remaining Bicillin L-A stock for children, and return any excess Bicillin to their pharmacy or supplier for redistribution where appropriate. Updated patient information and clinical resources are now available in English, te reo Māori, Samoan and Tongan.
What practices need to do
General practices are asked to:
order Benzetacil and 1% lidocaine diluent
reserve remaining Bicillin L-A stock for priority patient groups, including children aged 13 years and under and others identified in the guidance
prescribe oral alternatives for first-episode Strep A sore throats and skin infections where appropriate
familiarise clinical staff with the transition and administration guidance before implementing the change.
Supporting patients and whānau
Te Whatu Ora | Health NZ has developed guidance to support conversations with patients and whānau about the change, including information for people transitioning from Bicillin to Benzetacil and advice for patients receiving subcutaneous injection of penicillin (SCIP). The resource also includes practical administration guidance and frequently asked questions for clinicians.
Please download and read the guidance document for full clinical recommendations, priority patient groups, administration advice, and patient information resources.