Spectinomycin

🧬 Cross-allergy: Aminoglycosides

JFDA label: TOGAMYCIN INJ 2GM/A

Indications

Approved

• Bacterial Infections — bacterial disease

Antimicrobial Spectrum

Expected / intrinsic spectrum (EUCAST breakpoints & labels) — not local resistance. Source: EUCAST v16.

Bacteria

Organism	Activity	MIC
Neisseria gonorrhoeae	Susceptible	64.0 mg/L

Class profile

gramStatus	Gram-
spectrumBreadth	Narrow
atypicalCoverage	No
isBactericidal	0
moaCategory	Protein synthesis inhibitor (30S ribosomal, 16S rRNA)
pdIndex	Time-dependent
postAntibioticEffect	None
mrsaCoverage	0
resistanceMechanisms	Ribosomal mutation (spectinomycin resistance),Methylation

Monitoring

Efficacy	Culture and susceptibility testing; clinical resolution (temperature, WBC, CRP, procalcitonin)
Toxicity	Renal function (dose adjustment in renal impairment); hepatic function for hepatically cleared agents; signs of C. difficile infection (diarrhoea)
Clinical pearl	Culture results guide de-escalation to narrower-spectrum therapy. Review antibiotic appropriateness at 48–72 h (antimicrobial stewardship).
Counseling	Complete the full course. Report persistent diarrhoea, rash, or lack of improvement after 48–72 h.

Chemistry & Properties

Formula	C14H24N2O7
Molecular weight	332.35 g/mol
IUPAC name	(1R,3S,5R,8R,10R,11S,12S,13R,14S)-8,12,14-trihydroxy-5-methyl-11,13-bis(methylamino)-2,4,9-trioxatricyclo[8.4.0.03,8]tetradecan-7-one
CAS	1695-77-8
PubChem CID	15541
InChIKey	UNFWWIHTNXNPBV-WXKVUWSESA-N
logP	-2.93 (XLogP -3.1)
Polar surface area	129.51 Ų
H-bond acceptors / donors	9 / 5
Drug-likeness (QED)	0.36
Lipinski violations	0

SMILES

CN[C@@H]1[C@H](O)[C@H](NC)[C@H]2O[C@@]3(O)C(=O)C[C@@H](C)O[C@H]3O[C@@H]2[C@H]1O

Biology & Pharmacokinetics

Pharmacokinetics predicted

Bioavailability	70.0%
Half-life	3.124 h
Volume of distribution	0.144 L/kg
Protein binding	9.3%
BBB penetrant	No

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)P-gp (Substrate)

Drug–drug interactions (1, DDInter)

Interacting drug	Severity	Management
Picosulfuric acid	moderate

Registered Products (1)

Brand	Form / strength	Pack	Agent	Citizen (JOD)
TOGAMYCIN INJ 2GM/A	Powder for Injection 2 g	VIAL+SOLVENT	Khoury Drug Store	3.800