Bactericidal against N. gonorrhoeae (historical MIC90 ≤ 32 µg/ml); reduced activity against N. meningitidis and Treponema.
Binding to the S12 protein of the 30S ribosomal subunit (site distinct from streptomycin) → inhibition of translation initiation; does not cause mRNA misreading (unlike classical aminoglycosides).
IM: 100% bioavailability; plasma peak ~ 1 h (2 g dose); poor CSF penetration.
Minimal metabolism; ~ 100% unchanged renal excretion (glomerular filtration).
~ 2.5 h (normal); prolonged in renal impairment.
No documented drug–drug interactions for this medicine.
No documented food or drink interactions.
Spectinomycin is predominantly renally excreted — caution in renal impairment (no validated formal dose adjustment, monitor).
Consider alternatives in severe renal impairment; monitor renal function.
Prontuário Terapêutico INFARMED, 7.3 (spectinomycin — renal pharmacokinetics).
No entry in the Prontuário Annex 1; IM spectinomycin is an alternative in pregnancy gonorrhoea for cefalosporin-allergic patients (CDC/WHO guidelines list it when no alternative exists). Human data are limited but show no teratogenicity signal; EMC recommends use only if clearly necessary.
Use only when no alternative exists (allergy) and treatment is mandatory (untreated gonorrhoea harms pregnancy).
Milk excretion not characterised; use with caution and monitor the infant (gut flora).
EMC-UK (MHRA) — Spectinomycin SmPC (Trobicin): https://www.medicines.org.uk/emc/product/2997/smpc (section 4.6). CDC STI Treatment Guidelines (gonorrhoea in pregnancy).
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
