**3.5 Spectinamide 1810 (Spectinamide)**

Spectinamides are semisynthetic derivatives of spectinomycin with a narrow spectrum activity against *M. tuberculosis* and present its activity through selective inhibition of the bacterial S16 ribosomal subunit. One factor that contributes to their potent antitubercular activity is the evasion of efflux through the Rv1258c efflux pump. This feature makes spectinamides promising candidates against MDR TB, which have been shown to upregulate efflux pumps [29]. Two derivatives, 1599 and 1810 were investigated for their combinational effect in an infected mice model co-currently administering different combinations of the derivatives with Bdq, Emb, Inh, levofloxacin, linezolid, moxifloxacin, PA-824, Pza, and Rif. The researchers showed that spectinamide 1599 showed synergistic activity in combination with rifampicin and pyrazinamide [30]. Spectinamide 1810 is currently in pre-clinical investigation and being developed by Microbiotix, Inc.
