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Notice to Readers: Discontinuation of Spectinomycin
In January 2006, CDC learned that Pfizer, Inc. (New York, New York) had discontinued U.S. distribution of
spectinomycin (Trobicin®) in November 2005; remaining inventory will expire in May 2006. No other pharmaceutical
company manufactures or sells spectinomycin in the United States. Pfizer is continuing to distribute spectinomycin outside the
United States for the international market. CDC and the Food and Drug Administration are working with Pfizer to
make spectinomycin available again in the United States and will update this information as soon as possible.
Historically, spectinomycin has been used to treat persons
infected with Neisseria gonorrhoeae who cannot receive one
of the two first-line treatments (i.e., fluoroquinolones or
third-generation cephalosporins) currently recommended for treatment
of uncomplicated gonococcal infection (1). Relatively few indications exist for which spectinomycin is the preferred treatment
option for N. gonorrhoeae; these include 1) pregnant women with penicillin or cephalosporin allergy (fluoroquinolones are
contraindicated during pregnancy), 2) persons with penicillin or cephalosporin allergies who
reside in areas with a high prevalence of
quinolone-resistant N. gonorrhoeae
(1,2), and 3) men with penicillin or cephalosporin allergies who have sex with men
(3). No acceptable alternatives to spectinomycin therapy are currently available. Persons with penicillin or cephalosporin allergies who cannot
receive fluoroquinolones can be desensitized to cephalosporins before treatment
(4). Although 2 grams of azithromycin orally in a single
dose is effective against uncomplicated gonococcal infection, no data are available to assess the safety and efficacy of this regimen in
pregnant women. Moreover, concerns exist regarding the emergence of antimicrobial resistance if azithromycin is used widely in the treatment
of N. gonorrhoeae.
Park Miguel A, Li JTC. Diagnosis and management of penicillin allergy. Mayo Clin Proc 2005;80:405--10.
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