| SPECTINOMYCIN HYDROCHLORIDE
Classifications: antibiotic; Therapeutic: antibiotic
Pregnancy Category: B
400 mg injection
Antibiotic produced by Streptomyces spectabilis. Action is usually bacteriostatic. Spectinomycin appears to exert its bacteriostatic effect by binding to the 30S ribosomal
subunit, interfering with bacterial protein synthesis.
Variable activity against a wide variety of gram-negative and gram-positive organisms. Inhibits majority of Neisseria gonorrhoeae strains; effective for urethral and anorectal infections, but not pharyngeal.
Only for treatment of uncomplicated gonorrhea in patients sensitized or resistant to penicillin or other effective drugs
approved by US Centers for Disease Control and Prevention.
Disseminated gonococcal infections caused by penicillinase-producing strains of N. gonorrhoeae (PPNG) and sexually transmitted epididymoorchitis.
Safe use in infants and children <8 y is not established.
History of allergies; pregnancy (category B), lactation.
Route & Dosage
Adult: IM 2 g as single dose
Child: IM <45 kg, 40 mg/kg (max: 2 g); >45 kg, use adult dosing
Adult: IM 2 g q12h for 7 d or until switched to oral medication
Child (≥8 y, ≥45 kg): IM 2 g q12h for 7 d
- Give IM injection deep into upper outer quadrant of gluteus. No more than 5 mL should be injected into single site (using
20-gauge needle). Injection may be painful.
- Reconstitute with supplied diluent (bacteriostatic water for injection with 0.9% benzyl alcohol). Shake vial vigorously
immediately after adding diluent and before withdrawing drug.
- Use solution within 24 h of reconstitution.
- Store at 15°30° C (59°86° F) unless otherwise directed.
Adverse Effects (≥1%)Skin: Pain and soreness at injection site,
urticaria, pruritus, transient rash. Body as a Whole:
Headache, dizziness, chills, fever, insomnia
, nervousness. GI:
Nausea, vomiting. Metabolic:
Decrease in Hgb, Hct, Clcr
, elevated serum alkaline phosphatase, ALT, BUN.
Readily absorbed from IM site. Peak:
1 h. Metabolism:
In liver. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Observe patient for 4560 min after injection. Systemic anaphylaxis has been reported (apprehension, pruritus, hypertension,
abdominal pain, collapse).
- Obtain serologic tests for syphilis at time of diagnosis in patients with gonorrhea and again after 3 mo.
- Monitor clinical effectiveness of drug to detect antibiotic resistance.
- Culture all gonococcal infection sites 37 d after spectinomycin therapy is completed to verify eradication of infection.
- Lab tests: Monitor Hgb and Hct when multiple doses are required.
Patient & Family Education
- Notify sexual partners of their risk of infection.
- Refrain from sexual intercourse until infection is resolved.