Spectinomycin

Pronouncation: (speck-TIN-oh-MY-sin)
Class: Anti-infective agent

Trade Names:
Trobicin
- Powder for injection 400 mg (as hydrochloride) per mL when reconstituted

Pharmacology

Inhibits protein synthesis in bacterial cells (30S ribosomal subunit).

Pharmacokinetics

Absorption

Rapid after IM injection. Following a 2 g dose, C _max is about 100 mcg/mL at approximately 1 h; and 160 mcg/mL 2 h after a 4 g dose. Eight hours after a 2 or 4 g dose, average serum levels are 15 and 31 mcg/mL, respectively.

Indications and Usage

Treatment of acute gonorrheal urethritis and proctitis in men and acute gonorrheal cervicitis and proctitis in women.

Contraindications

Standard considerations.

Dosage and Administration

Adults

IM 2 g deep into upper outer quadrant of the gluteal muscle. In geographic locations where antibiotic resistance is known to be prevalent, treat with 4 g divided between 2 gluteal injection sites.

Storage/Stability

Store unopened vials at controlled room temperature (68° to 77°F). Store reconstituted suspension at controlled room temperature and use within 24 h. Discard any unused solution. Do not save unused solution for later administration.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Dizziness; insomnia.

Dermatologic

Soreness at injection site; urticaria.

GI

Nausea.

Genitourinary

Decreased urine output.

Hypersensitivity

Anaphylaxis or anaphylactoid reactions.

Lab Tests

Decreased hemoglobin, hematocrit, and Ccr; elevated alkaline phosphatase, BUN, and ALT.

Miscellaneous

Chills; fever.

Precautions

Pregnancy

Category B .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Benzyl alcohol

Contains benzyl alcohol, which has been associated with fatal gasping syndrome in premature infants and increased incidence of neurologic and other complications.

Efficacy

Monitor to detect evidence of Neisseria gonorrhoeae resistance.

Syphilis

Spectinomycin is not effective in treating syphilis, and high doses for short periods of time to treat gonorrhea may mask or delay symptoms of incubating syphilis.

Patient Information

Advise patient or caregiver that medication will be prepared and administered by a health care provider in a health care setting.
Advise patient to report injection-site pain or redness.