{"id":3257,"date":"2017-03-29T06:46:39","date_gmt":"2017-03-29T10:46:39","guid":{"rendered":"http:\/\/allphasepharma.com\/dir\/?p=3257"},"modified":"2025-09-20T19:10:38","modified_gmt":"2025-09-21T01:10:38","slug":"fake-news-spectinomycin","status":"publish","type":"post","link":"https:\/\/allphasepharma.com\/dir\/2017\/03\/29\/3257\/fake-news-spectinomycin\/","title":{"rendered":"The CDC and Spectinomycin"},"content":{"rendered":"

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Pfizer discontinued US distribution of spectinomycin (Trobicin\u00ae<\/sup>) in November 2005; remaining inventory expired in May 2006\u00a0[1]<\/a>. Nonetheless, at the FDA website we still find a Package Insert for Trobicin updated as late as Aug 2012, a thin 6-page leaflet which seems to have survived from the 80s.<\/p>\n

The drug is on the WHO List of Essential Medicines\u00a0[2]<\/a>\u00a0for the indications of uncomplicated anogenital and disseminated GC infection, so we should know a bit about it.<\/p>\n

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Spectinomycin<\/figcaption><\/figure>\n

Spectinomycin is indicated as a 2 g or 4 g IM injection; the breakpoint for GC is 64 mg\/L. In the Adverse Event section, we find soreness at the injection site but not much else. Yes, you read it right: this aminocyclitol is different from all others. First, it does not have the aminoglycoside characteristics of renal, nephro- and ototoxicity\u00a0[3]<\/a>,[4]<\/a>. Second, while other aminoglycosides have a Class C or D pregnancy listing, spectinomycin sports a \u2018safe to use\u2019 Class B label. The chemical structure is certainly not reminiscent of a streptomycin or plazomicin, a difference even evident to the eyes of non-chemists.<\/p>\n

Modern literature on spectinomycin is hard to come by. Without a sponsor, the drug is rarely investigated and there is no monograph devoted to spectinomycin\u00a0since the 80s. Textbooks of infectious diseases still mention the drug, almost as an afterthought [4]<\/a>. We are grateful for the reviews on chemistry, microbiology and pharmacology in Bryskier’s textbook [5]<\/a> highlighting the excellent activity of spectinomycin and its close relative, trospectomycin, against GC.<\/p>\n

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Streptomycin<\/figcaption><\/figure>\n

The most recent CDC Treatment Guidelines for STD still list spectinomycin as an alternative drug for urogenital and anogenital GC. The document makes mention of an\u00a0often-quoted GC study from 1995 in which spectinomycin treatment was successful in 98%\u00a0[6]<\/a>. Interestingly, in the same paragraph CDC also mentions that the drug is ‘expensive’, presumably a significant drawback.<\/p>\n

Since when are drug costs an issue for our regulators? We tried to find out more about the costs of this old drug and found a few price quotes, from X-US manufacturers, of course:<\/p>\n