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
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Definition (NCI) | An aminoglycoside antibiotic derived from Streptomyces griseus with antibacterial activity. Streptomycin irreversibly binds to the 16S rRNA and S12 protein within the bacterial 30S ribosomal subunit. As a result, this agent interferes with the assembly of initiation complex between mRNA and the bacterial ribosome, thereby inhibiting the initiation of protein synthesis. In addition, streptomycin induces misreading of the mRNA template and causes translational frameshift, thereby results in premature termination. This eventually leads to bacterial cell death. |
Definition (MSH) | An antibiotic produced by the soil actinomycete Streptomyces griseus. It acts by inhibiting the initiation and elongation processes during protein synthesis. |
Definition (CSP) | first of the aminoglycoside antibiotics to be isolated; derived from Streptomyces griseus. |
Concepts | Antibiotic (T195) , Carbohydrate (T118) |
MSH | D013307 |
SnomedCT | 387223008, 40877002 |
LNC | LP16282-3, MTHU008482 |
English | Streptomycin, streptomycin, D-Streptamine, O-2-deoxy-2-(methylamino)-alpha-L-glucopyranosyl-(1-2)-O-5-deoxy-3-C-formyl-alpha-L-lyxofuranosyl-(1-4)-N,N'-bis(aminoiminomethyl)-, Streptomycin [Chemical/Ingredient], STREPTOMYCIN, antibacterial streptomycin, streptomycin (medication), Streptomycin (product), Streptomycin (substance) |
Swedish | Streptomycin |
Czech | streptomycin |
Finnish | Streptomysiini |
Russian | STREPTOMITSIN, СТРЕПТОМИЦИН |
Japanese | ストレプトマイシン |
Polish | Streptomycyna |
Spanish | estreptomicina (producto), estreptomicina (sustancia), estreptomicina, Estreptomicina |
French | Streptomycine |
German | Streptomycin |
Italian | Streptomicina |
Portuguese | Estreptomicina |