|
This information has been developed and provided by an independent third-party source. Merck & Co., Inc. does not endorse and is not responsible for the accuracy of the content, or for practices or
standards of non-Merck sources.
Medication Safety Issues
Sound-alike/look-alike issues:
Trobicin® may be confused with tobramycin
Pronunciation
(spek ti noe MYE sin)
U.S. Brand Names
Index Terms
Generic Available
No
Pharmacologic Category
Use: Labeled Indications
Treatment of uncomplicated gonorrhea
Pregnancy Risk Factor
B
Lactation
Enters breast milk/effect on infant unknown
Contraindications
Hypersensitivity to spectinomycin or any component of the formulation
Warnings/Precautions
Concerns related to adverse effects:
• Superinfection: Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment.
Disease-related concerns:
• Syphilis: Since spectinomycin is ineffective in the treatment of syphilis and may mask symptoms, all patients should be tested for syphilis at the time of gonorrheal diagnosis and 3 months later.
Special populations:
• Pediatrics: Safety and efficacy have not been established in children.
Adverse Reactions
<1%: Chills, dizziness, headache, nausea, pain at injection site, pruritus, rash, urticaria, vomiting
Drug Interactions
Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Risk D: Consider therapy modification
Storage
Use reconstituted solutions within 24 hours.
Reconstitution
Reconstitute with supplied diluent only.
Mechanism of Action
A bacteriostatic antibiotic that selectively binds to the 30s subunits of ribosomes, and thereby inhibiting bacterial protein synthesis
Pharmacodynamics/Kinetics
Duration: Up to 8 hours
Absorption: I.M.: Rapid and almost complete
Distribution: Concentrates in urine; does not distribute well into the saliva
Half-life elimination: 1.7 hours
Time to peak: ?1 hour
Excretion: Urine (70% to 100% as unchanged drug)
Dosage
I.M.:
Children:
<45 kg: 40 mg/kg/dose 1 time (ceftriaxone preferred)
?45 kg: Refer to adult dosing.
Children >8 years who are allergic to PCNS/cephalosporins may be treated with oral tetracycline
Adults:
Uncomplicated urethral, cervical, pharyngeal, or rectal gonorrhea: 2 g deep I.M. or 4 g where antibiotic resistance is prevalent 1 time; 4 g (10 mL) dose should be given as two 5 mL injections, followed by adequate chlamydial treatment (doxycycline 100 mg twice daily for 7 days)
Disseminated gonococcal infection: 2 g every 12 hours
Dosing adjustment in renal impairment: None necessary
Hemodialysis: 50% removed by hemodialysis
Administration: I.M.
For I.M. use only.
Patient Education
This medication can only be administered I.M. You will need to return for follow-up blood tests. Breast-feeding precaution: Consult prescriber if breast-feeding.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause dizziness
Mental Health: Effects on Psychiatric Treatment
None reported
Nursing: Physical Assessment/Monitoring
Assess knowledge/teach patient sexually transmitted diseases precautions. Monitor effectiveness and evaluate laboratory results.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Injection, powder for reconstitution, as hydrochloride:
Trobicin®: 2 g [diluent contains benzyl alcohol] [DSC]
References
U.S. Department of Health and Human Services, “1993 Sexually Transmitted Diseases Treatment Guidelines,” MMWR Recomm Rep, 1993, 42(RR-14).
International Brand Names
Lexi-Comp.com
Last full review/revision August 2008
Content last modified August 2008
| 
