Saturday, June 17, 2006


Spectinomycin injection

Active Ingredients: Spectinomycin
Representative Names: Trobicin

What is spectinomycin injection?

SPECTINOMYCIN (Trobicin®) is an antibiotic. It treats and cures gonorrhea (a type of sexually transmitted or venereal disease). Generic spectinomycin is not available

What should my health care professional know before I receive spectinomycin?

They need to know if you have any of these conditions:

syphilis - you need to be tested for syphilis before treatment with spectinomycin is started
an unusual or allergic reaction to spectinomycin or other antibiotics, other medicines, foods, dyes or preservatives
pregnant or trying to get pregnant

How should I use this medicine?

Spectinomycin is for injection into a muscle

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed

What if I miss a dose?

Spectinomycin is usually given as a single dose. If you do need more than one dose it is important not to miss your appointment. If you miss a dose, get it as soon as you can

What drug(s) may interact with spectinomycin?

There are no interactions known.

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking spectinomycin?

Tell your prescriber or health care professional if your symptoms do not improve in a few days
Anyone you have had sex with needs treatment for gonorrhea. Use a condom to stop reinfection of either you or your sexual partner

You may get dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how spectinomycin affects you

What side effects may I notice from receiving spectinomycin?

Side effects that you should report to your prescriber or health care professional as soon as possible:

fever or chills
skin rash, itching
Minor side effects include:
irritation or pain at the injection site
nausea, vomiting
reduced urine output

Where can I keep my medicine?

Keep out of the reach of children
Store the dry powder at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Do not freeze the diluent. After dissolving the powder, keep injection solution at room temperature between 15 and 30 degrees C (59 and 86 degrees F), and use within 24 hours. Throw away any unused injection solution

St. John's Health


Discontinuation of Spectinomycin

JAMA. 2006;295:2245.

MMWR. 2006;55:370

In January 2006, CDC learned that Pfizer, Inc. (New York, New York) had discontinued U.S. distribution of spectinomycin (Trobicin®) in November 2005; remaining inventory will expire in May 2006. No other pharmaceutical company manufactures or sells spectinomycin in the United States. Pfizer is continuing to distribute spectinomycin outside the United States for the international market. CDC and the Food and Drug Administration are working with Pfizer to make spectinomycin available again in the United States and will update this information as soon as possible.

Historically, spectinomycin has been used to treat persons infected with Neisseria gonorrhoeae who cannot receive one of the two first-line treatments (i.e., fluoroquinolones or third-generation cephalosporins) currently recommended for treatment of uncomplicated gonococcal infection.1 Relatively few indications exist for which spectinomycin is the preferred treatment option for N. gonorrhoeae; these include (1) pregnant women with penicillin or cephalosporin allergy (fluoroquinolones are contraindicated during pregnancy), (2) persons with penicillin or cephalosporin allergies who reside in areas with a high prevalence of quinolone-resistant N. gonorrhoeae,1-2 and (3) men with penicillin or cephalosporin allergies who have sex with men.3

No acceptable alternatives to spectinomycin therapy are currently available. Persons with penicillin or cephalosporin allergies who cannot receive fluoroquinolones can be desensitized to cephalosporins before treatment.4 Although 2 grams of azithromycin orally in a single dose is effective against uncomplicated gonococcal infection, no data are available to assess the safety and efficacy of this regimen in pregnant women. Moreover, concerns exist regarding the emergence of antimicrobial resistance if azithromycin is used widely in the treatment of N. gonorrhoeae.


1. CDC. Sexually transmitted diseases treatment guidelines 2002. MMWR. 2002;51(No. RR-6):1-80. PUBMED
2. CDC. Increases in fluoroquinolone-resistant Neisseria gonorrhoeae—Hawaii and California, 2001. MMWR. 2002;51:1041-1044. PUBMED
3. CDC. Increases in fluoroquinolone-resistant Neisseria gonorrhoeae among men who have sex with men—United States, 2003, and revised recommendations for gonorrhea treatment, 2004. MMWR. 2004;53:335-338. PUBMED
4. Park MA, Li JTC. Diagnosis and management of penicillin allergy. Mayo Clin Proc. 2005;80:405-410. ISI PUBMED

Journal of the American Medical Association