Spectinomycin
An aminocyclitol antibiotic obtained from cultures of Streptomyces spectabilis.
Mechanism of effect
Usually bacteriostatic in action. Inhibits protein synthesis in susceptible bacteria by binding to 30S ribosomal subunits.
Pharmacokinetics
-Absorption and Bioavailability
Not absorbed from GI tract; must be given parenterally.
Rapidly absorbed following IM administration; peak serum concentrations attained within 1–2 hours.
-Distribution
Not known whether spectinomycin crosses the placenta or is distributed into milk.
-Plasma Protein Binding
Not substantially bound to plasma proteins.
-Elimination
70–100% of a single IM dose is excreted in urine by glomerular filtration as spectinomycin or a microbiologically active metabolite.
Hemodialysis has been reported to aid in the removal of spectinomycin.
-Half-life
1.2–2.8 hours in adults.
Dosage
-Pediatric Patients
Gonorrhea and Associated Infections
Uncomplicated Urethral, Cervical, or Rectal Gonorrhea
Children weighing <45 kg†: 40 mg/kg (maximum 2 g) as a single dose. IM
Adolescents and children weighing ≥45 kg†: 2 g as a single dose.
Manufacturer states that a single 4-g dose may be preferred in geographic areas where resistance is known to be prevalent; the dose can be divided and given into 2 different gluteal injection sites.
Disseminated Gonorrhea
Adolescents and children weighing ≥45 kg†: 2 g every 12 hours; IM , continue for 24–48 hours after improvement begins and switch to an oral regimen (e.g., cefixime, cefpodoxime) to complete ≥1 week of treatment.
-Adults
Gonorrhea and Associated Infections
Uncomplicated Urethral, Cervical, or Rectal Gonorrhea
2 g as a single dose. IM,
Manufacturer states that a single 4-g dose may be preferred in geographic areas where resistance is known to be prevalent; the dose can be divided and given into 2 different gluteal injection sites.
Disseminated Gonorrhea
2 g every 12 hours; IM , continue for 24–48 hours after improvement begins and switch to an oral regimen (e.g., cefixime, cefpodoxime) to complete ≥1 week of treatment.
Drug contraindications
excessive sensitivity to the drug or its componentAlerts
- Hypersensitivity Reactions
- Anaphylaxis or anaphylactoid reactions have been reported rarely.
- Use with caution in patients with history of allergies.
- Serious hypersensitivity reactions should be treated with appropriate therapy (e.g., epinephrine, corticosteroids, maintenance of an adequate airway, oxygen) as indicated.
- Points of recommendations: To reduce development of drug-resistant bacteria and maintain effectiveness of spectinomycin and other antibacterials, use only for treatment or prevention of infections proven or strongly suspected to be caused by susceptible bacteria.
Ask a Pharmacist