TOGAMYCIN

Indications

• Gonorrhea
• Neisseria gonorrhoeae infection

Dosage

Children: Refer to BNF for Children for appropriate dosing information.

Adults: Refer to specific BNF guidelines for dosing details.

Mechanism of action

Spectinomycin acts as an inhibitor of protein synthesis by binding to the 30S ribosomal subunit in bacterial cells. This binding interferes with the process of translation, leading to bactericidal effects.

Pharmacodynamics

Spectinomycin demonstrates significant antibacterial activity against Neisseria gonorrhoeae, with minimum inhibitory concentrations ranging from 7.5 to 20 mcg/mL. Its unique mechanism involves regional effects on ribosomal structure, which disrupts the normal function of bacterial protein synthesis.

Pharmacokinetics

Spectinomycin is administered via intramuscular injection and achieves peak plasma concentrations within 1 to 2 hours post-administration. The drug is widely distributed in body tissues and fluids, including the renal system, and is primarily excreted unchanged in the urine. The half-life of spectinomycin is approximately 2 to 3 hours, though this may vary based on renal function.

Contra-indications

• Hypersensitivity to spectinomycin or any component of the formulation
• Severe renal impairment

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Rash
• Allergic reactions

Interactions

• May interact with other aminoglycoside antibiotics
• Concurrent use with nephrotoxic or ototoxic drugs may increase the risk of toxicity

Precautions

• Use with caution in patients with renal impairment
• Monitor renal function during treatment
• Assess for a history of allergy to antibiotics

Pregnancy

Safety in pregnancy has not been established. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known whether spectinomycin is excreted in human milk. Caution should be exercised when administering to nursing mothers.

Storage

Store at room temperature, away from light and moisture. Keep out of reach of children.

Formulations

• Spectinomycin injection for intramuscular use

Mechanism of action

Spectinomycin is an inhibitor of protein synthesis in the bacterial cell; the site of action is the 30S ribosomal subunit. It is bactericidal in its action.

Pharmacodynamics

Spectinomycin is an aminocyclitol antibiotic produced by a species of soil microorganism designated as S<i>treptomyces spectabilis</i>. In vitro studies have shown spectinomycin to be active against most strains of <i>Neisseria gonorrhoeae</i> (minimum inhibitory concentration <7.5 to 20 mcg/mL). Footprint studies indicate that spectinomycin exerts regional effects on ribosomal structure.