Akiyoshi M, Yano S, Ikeda T
Jpn J Antibiot. 1976 Sep;29(9):771-82.
Spectinomycin is an aminocyclitol antibiotic, but different in chemical structure from other aminocyclitol antibiotics such as streptomycin, kanamycin and gentamicin. Spectinomycin clinically has been proven to be highly effective in the intramuscular single-dose treatment of gonorrhea. According to NOVAK et al. (1974), all evidence from pharmacological and clinical efficacy studies to date indicates that spectinomycin is free from ototoxic effects at the dose levels recommended for single-dose treatment of gonorrhea (2 or 4 g) or repeated i.m. or i.v. doses, 8g/day. The present experimental study has been made to evaluate the ontoxocic effects of spectinomycin in Hartley strain guinea pigs given i.m. a single-high dose (800 mg/kg or 1,600 mg/kg) and repeated-slightly higher dose (80 mg/kg or 160 mg/kg daily for 4 weeks) respectively. Differential frequency pinna reflex test in frequency range from 20 KHz to 500 Hz revealed that no animals showed disappearance of pinna reflex in the frequencies tested. Histologic examination in serial celloidin sections of the cochlea and vestibulum disclosed that a few animals given a single-high dose of spectinomycin (800 mg/kg or 1,600 mg/kg) and repeated-slightly higher dose or spectinomycin (80 mg/kg daily for 4 weeks) respectively showed limited mild damage of outer hair cells in the spiral organ and of hair cells in the vestibular organ. There were histologically a few focal necrosis in the liver and scattered interstitial cell infiltration around the proximal convoluted tubules which are lined with regenerated epithelial cells in some animals given the single-high dose (800 mg/kg or 1,600 mg/kg) or repeated-slightly higher dose (80 mg/kg or 160 mg/kg daily for 4 weeks) of spectinomycin. Positive correlation between the extent of the hair cell damage and the injury of the liver and kidney was not confirmed. The present study suggests that administration of spectinomycin at the dose levels recommended for single-dose treatment of gonorrhea (2 or 4 g) most probably is free from ototoxic effect.
壮观霉素是一种氨基环醇类抗生素，但化学结构与其他氨基环醇类抗生素如链霉素、卡那霉素和庆大霉素不同。临床证明，壮观霉素在淋病的肌肉注射单剂量治疗中非常有效。根据诺瓦克等人（1974年）的研究，迄今为止，药理学和临床疗效研究的所有证据表明，在淋病单剂量治疗推荐剂量（2或4克）或重复肌肉注射或静脉注射剂量（每天8克）下，壮观霉素没有耳毒性作用。本实验研究旨在评估分别给哈特利豚鼠肌肉注射单次高剂量（800毫克/千克或1600毫克/千克）和重复稍高剂量（每天80毫克/千克或160毫克/千克，持续4周）后壮观霉素的耳毒性作用。在20千赫至500赫兹频率范围内的不同频率耳廓反射测试表明，在所测试的频率中，没有动物出现耳廓反射消失的情况。对耳蜗和前庭的连续火棉胶切片进行组织学检查发现，分别给予单次高剂量壮观霉素（800毫克/千克或1600毫克/千克）和重复稍高剂量壮观霉素（每天80毫克/千克，持续4周）的少数动物，其螺旋器中的外毛细胞和前庭器官中的毛细胞有有限的轻度损伤。在给予单次高剂量（800毫克/千克或1600毫克/千克）或重复稍高剂量（每天80毫克/千克或160毫克/千克，持续4周）壮观霉素的一些动物中，肝脏有一些局灶性坏死，近端曲管周围有散在的间质细胞浸润，近端曲管内衬有再生上皮细胞。毛细胞损伤程度与肝脏和肾脏损伤之间未证实存在正相关。本研究表明，以淋病单剂量治疗推荐剂量（2或4克）使用壮观霉素很可能没有耳毒性作用。
