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