Drug information of Streptomycin

Streptomycin

Drug group: Aminoglycosides

Streptomycin is an aminoglycoside antibiotic produced by the soil actinomycete Streptomyces griseus. It acts by binding to the 30S ribosomal subunit of susceptible organisms and disrupting the initiation and elongation steps in protein synthesis. It is bactericidal due to effects that are not fully understood.

Mechanism of effect

Streptomycin works by killing sensitive bacteria by stopping the production of essential proteins needed by the bacteria to survive.

Pharmacodynamic

Interferes with normal bacterial protein synthesis by binding to the 30S ribosomal subunits

Pharmacokinetics

Absorption : IM : well absorbed; not absorbed from gut
Distribution : to extracellular fluid including serum, abscesses, ascitic, pericardial, pleural, synovial, lymphatic, & peritoneal fluids; crosses placenta; small amounts enter breast milk
Protein Bound : 34%
Half-life elimination : newborns: 4-10 hr; adults: 2-4.7 hr, prolonged with renal impairment
Peak Plasma Time : within 1 hr
Excretion: urine (90% as unchanged drug); feces, saliva, sweat, & tears (<1%)

Drug indications

tuberculosis

Dosage

Moderate-Severe Infections: 1-2 g/day IM divided q6-12hr; no more than 2 g/day
Tuberculosis: Daily therapy: 15 mg/kg IM qDay; no more than 1 g/day
Twice weekly therapy: 25-30 mg/kg IM 2 times/week; no more than 1.5 g/day
Tularemia: 1-2 g IM in divided doses for 7-10 days or until patient is afebrile for 5-7 days
Plague: 15 mg/kg IM q12hr for minimum 10 days
Streptococcal Endocarditis: 1 g IM q12hr for 7 days, THEN 500 mg q12hr for 7 days, concomitant with penicillin
If >60 years old, 500 mg q12hr for entire 14 days
Enterococcal Endocarditis: 1 g IM q12hr for 2 weeks, THEN 500 mg q12hr for 4 weeks, concomitant with penicillin
Brucellosis: 1 g IM qDay/BID for 1 week, THEN qDay for 1 week in conjunction with doxycycline or tetracycline

Alerts

Streptomycin May cause nephrotoxicity and neurotoxicity. Avoid concurrent use of nephrotoxic/neurotoxic drugs.
May cause neuromuscular blockade and respiratory paralysis, especially when given after anesthesia or muscle relaxants. Use the parenteral form only where appropriate audiometric and laboratory testing facilities are available.

Points of recommendation

Streptomycin only works against bacteria ; it does not treat viral infections (eg, the common cold).
• Be sure to use streptomycin for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
• Long-term or repeated use of streptomycin may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
• Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur.
This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.

Pregnancy level

D


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