Pharmacology · Other antibacterials
Spectinomycin !
An injectable aminocyclitol that binds the 30S ribosome. A WHO second-choice drug for gonorrhoea when first-line treatment cannot be used.
Updated 2026-11-01
The figure shows spectinomycin bound to the 30S subunit of the Escherichia coli ribosome.
Mechanism of action
Spectinomycin binds the 30S ribosomal subunit and blocks the movement of the ribosome along the messenger RNA, so protein synthesis stops. It is an aminocyclitol made by Streptomyces spectabilis; ribosome structures show it stalling the ribosome midway through translocation.
- Given by intramuscular injection
- Binds the 30S ribosomal subunit
- Ribosome translocation is blocked
- Protein synthesis stops in the gonococcus
Pharmacokinetics
- Absorption
- Given by intramuscular injection.
Indications
- Gonococcal urethritis, cervicitis and proctitis (WHO second choice) Gonorrhoea →
Adverse effects
- Allergic skin reactions (it is a skin sensitiser)
Contraindications
- Allergy to spectinomycin
Key interactions
- Other drugs
- No major interactions are described for a single dose.
What is monitored
- Observation after the injection for allergic reactions
- Test of cure and partner treatment as per guidelines
Administration and safety
- Deep intramuscular injection
- Reconstituted only with the diluent the product names
Nursing care
- Observe the patient after the injection
- Explain that partners are tested and treated
- Teach to report rash or breathing difficulty
Pregnancy and breastfeeding
Data are limited; used in pregnancy when the benefit justifies the risk.
Test yourself
Think of the answer, then tap the question to see it.
Where does spectinomycin bind?
On the 30S ribosomal subunit, blocking translocation.
For which infection is it used?
Gonorrhoea, as a WHO second-choice drug.
How is it given?
By intramuscular injection.
Related drugs
Related conditions
← Back to the class: Other antibacterials
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: eEML - Electronic Essential Medicines List (World Health Organization, 2025); Spectinomycin (PubChem (U.S. National Library of Medicine), 2026); Crystal structure of the bacterial ribosome from Escherichia coli in complex with spectinomycin. (RCSB Protein Data Bank, 2026); Elongating 70S ribosome complex in a spectinomycin-stalled intermediate state of translocation bound to EF-G in an active, GTP conformation (INT1) (RCSB Protein Data Bank, 2026).
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Representative model, for educational purposes only.