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Streptomycin information from DrugsUpdate  

See Available Brands of Streptomycin in India

P - Contraindicated in pregnancy
L - Caution when used during lactation

Streptomycin is an antibiotic drug, the first of a class of drugs called aminoglycosides to be discovered, and was the first antibiotic remedy for tuberculosis. It is derived from the actinobacterium Streptomyces griseus. Streptomycin is a bactericidal antibiotic. Streptomycin cannot be given orally, but must be administered by regular intramuscular injections. An adverse effect of this medicine is ototoxicity, which can lead to hearing loss.

Pharmacodynamics

Pharmacokinetics

Information Not Available

Streptomycin Indications / Streptomycin Uses

Information Not Available

Streptomycin Adverse Reactions / Streptomycin Side Effects

Giddiness, vertigo, tinnitus, ataxia, hypersensitivity reactions, ototoxicity and nephrotoxicity. Anaphylactic shock, aplastic anaemia And agranulocytosis. Stevens-Johnson syndrome and toxic epidermal necrolysis.

Precautions

General

Prescribing Streptomycin in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Baseline and periodic caloric stimulation tests and audiometric tests are advisable with extended Streptomycin therapy. Tinnitus, roaring noises, or a sense of fullness in the ears indicates need for audiometric examination or termination of Streptomycin therapy or both.
Care should be taken by individuals handling Streptomycin for injection to avoid skin sensitivity reactions. As with all intramuscular preparations, Streptomycin Sulfate Injection should be injected well within the body of a relatively large muscle and care should be taken to minimize the possibility of damage to peripheral nerves.
Extreme caution must be exercised in selecting a dosage regimen in the presence of pre-existing renal insufficiency. In severely uremic patients a single dose may produce high blood levels for several days and the cumulative effect may produce ototoxic sequelae. When Streptomycin must be given for prolonged periods of time alkalinization of the urine may minimize or prevent renal irritation.
A syndrome of apparent central nervous system depression, characterized by stupor and flaccidity, occasionally coma and deep respiratory depression, has been reported in very young infants in whom Streptomycin dosage had exceeded the recommended limits. Thus, infants should not receive Streptomycin in excess of the recommended dosage.
In the treatment of venereal infections such as granuloma inguinale, and chancroid, if concomitant syphilis is suspected, suitable laboratory procedures such as a dark field examination should be performed before the start of treatment, and monthly serologic tests should be done for at least four months.
As with other antibiotics, use of this drug may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, appropriate therapy should be instituted.


 

Special Precautions

Information Not Available

Other Drug Interactions

Information Not Available

Other Interactions

Information Not Available

Dosage

Intramuscular Route Only

Adults: The preferred site is the upper outer quadrant of the buttock, (i.e., gluteus maximus), or the mid-lateral thigh.

Children: It is recommended that intramuscular injections be given preferably in the mid-lateral muscles of the thigh. In infants and small children the periphery of the upper outer quadrant of the gluteal region should be used only when necessary, such as in burn patients, in order to minimize the possibility of damage to the sciatic nerve.

The deltoid area should be used only if well developed such as in certain adults and older children, and then only with caution to avoid radial nerve injury. Intramuscular injections should not be made into the lower and mid-third of the upper arm. As with all intramuscular injections, aspiration is necessary to help avoid inadvertent injection into a blood vessel.

Injection sites should be alternated. As higher doses or more prolonged therapy with Streptomycin may be indicated for more severe or fulminating infections (endocarditis, meningitis, etc.), the physician should always take adequate measures to be immediately aware of any toxic signs or symptoms occurring in the patient as a result of Streptomycin therapy.

 TUBERCULOSIS
: The standard regimen for the treatment of drug susceptible tuberculosis has been two months of INH, rifampin and pyrazinamide followed by four months of INH and rifampin (patients with concomitant infection with tuberculosis and HIV may require treatment for a longer period). When Streptomycin is added to this regimen because of suspected or proven drug resistance.

      Streptomycin is usually administered daily as a single intramuscular injection. A total dose of not more than 120 g over the course of therapy should be given unless there are no other therapeutic options. In patients older than 60 years of age the drug should be used at a reduced dosage due to the risk of increased toxicity.
      Therapy with Streptomycin may be terminated when toxic symptoms have appeared, when impending toxicity is feared, when organisms become resistant, or when full treatment effect has been obtained. The total period of drug treatment of tuberculosis is a minimum of 1 year; however, indications for terminating therapy with Streptomycin may occur at any time as noted above.
 
TULAREMIA: One to 2 g daily in divided doses for 7 to 14 days until the patient is afebrile for 5 to 7 days.
  
PLAGUE: Two grams of Streptomycin daily in two divided doses should be administered intramuscularly. A minimum of 10 days of therapy is recommended.

  BACTERIAL ENDOCARDITIS
:
      Streptococcal endocarditis; in penicillin-sensitive alpha and non-hemolytic streptococcal endocarditis (penicillin MIC<0.1 mcg/mL), Streptomycin may be used for 2-week treatment concomitantly with penicillin. The Streptomycin regimen is 1 g b.i.d. for the first week, and 500 mg b.i.d. for the second week. If the patient is over  60 years of age, the dosage should be 500 mg b.i.d. for the entire 2- week period.

 Enterococcal endocarditis
: Streptomycin in doses of 1 g b.i.d. for 2 weeks and 500 mg b.i.d. for an additional 4 weeks is given in combination with penicillin. Ototoxicity may require termination of the Streptomycin prior to completion of the 6-week course of treatment.
 
      CONCOMITANT USE WITH OTHER AGENTS: For concomitant use with other agents to which the infecting organism is also sensitive: Streptomycin is considered a secondline agent for the treatment of gram-negative bacillary bactermia, meningitis, and pneumonia; brucellosis; granuloma inguinale; chancroid, and urinary tract infection.

For adults
: 1 to 2 grams in divided doses every six to twelve hours for moderate to severe infections. Doses should generally not exceed 2 grams per day.

For children: 20 to 40 mg/kg/day (8 to 20 mg/lb/day) in divided doses every 6 to 12 hours. (Particular care should be taken to avoid excessive dosage in children).

Sterile reconstituted solutions should be protected from light and may be stored at room temperature for one week without significant loss of potency

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.


List of Contraindications

Streptomycin and Pregnancy

Category D.

Streptomycin and Lactation

Because of the potential for serious adverse reactions in nursing infants from Streptomycin, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Streptomycin and Children

Information Not Available

Streptomycin and Geriatic

Information Not Available

Streptomycin and Other Contraindications

A history of clinically significant hypersensitivity to Streptomycin is a contraindication to its use. Clinically significant hypersensitivity to other aminoglycosides may contraindicate the use of Streptomycin because of the known cross-sensitivity of patients to drugs in this class.

Storage

Store dry powder under controlled room temperature 15°-30°C (59°-86°F).
PROTECT FROM LIGHT

Lab interference

Store dry powder under controlled room temperature 15°-30°C (59°-86°F).
PROTECT FROM LIGHT

Streptomycin brands in India:

Ambistryn-S Cipstryn Isos Streptomac Streptomycin

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