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Streptomycin

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Streptomycin

  • See Also
  1. Aminoglycoside
  • Indications
  1. Active Tuberculosis Treatment
    1. Multi-drug Tuberculosis Treatment regimen (typically 4 drug regimens)
  • Contraindications
  1. Pregnancy
  • Mechanism
  1. See Aminoglycoside
  2. Streptomycin is an AminoglycosideAntibiotic derived from Streptomyces griseus
  3. Bactericidal Antibiotic via Protein synthesis inhibition
    1. Binds 30s/50s ribosome site
  4. Does not penetrate CSF, and poorly penetrates infected cells
    1. Only 10% of drug penetrates Tb infected cells
  1. See Active Tuberculosis Treatment
  2. Adults
    1. Give 15 mg/kg (maximum 1 gram) IV or IM daily
  3. Older adults (age >60 years)
    1. Give 10 mg/kg (maximum 750 mg) IV or IM daily
  4. Children
    1. Give 20 to 40 mg/kg (maximum 1 gram) IM daily (FDA approved) OR
    2. Give 15 mg/kg (maximum 1 gram) IM daily (off label)
  • Adverse Effects
  1. See Aminoglycoside
  2. Aminoglycosides are associated with risk of Ototoxicity and nephrotoxicity (FDA black box warning)
    1. See Aminoglycoside for risk factors
  3. Cranial Nerve 8 and Vestibular toxicity
    1. Vertigo
    2. Decreased Hearing acuity or Deafness
  4. Acute Kidney Injury
  • Safety
  1. Pregnancy Category D
  2. Considered safe in Lactation
  3. Monitoring (baseline and monthly)
    1. Audiogram
    2. Renal Function
    3. Vestibular Testing
    4. Rhomberg testing
  • Pharmacokinetics
  1. Renal excretion
  • Resources
  1. Streptomycin Powder for Injection Solution (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=abd1f64e-4283-4370-aae8-3666316aa36e
  • References
  1. (2012) Med Lett Drugs Ther 10(116): 29-36