Streptomycin
Mechanism :
It is an aminoglycoside group of antibiotic used in the treatment of tuberculosis and infections like plague, tularaemia, brucellosis.
Indication :
- For the treatment of tuberculosis.
- May also be used in combination with other drugs to treat tularaemia (Francisella tularensis), plague (Yersinia pestis), severe M. avium complex, brucellosis, and enterococcal endocarditis (e.g. E. faecalis, E. faecium).
Contraindications :
Hypersensitivity to streptomycin or other aminoglycosides; severe hypersensitivity to sulfites; Concomitant live bacterial vaccines.
Dosing :
20-40 mg/kg (Maximum 1 g) IM once daily or 25-30 mg/kg (Maximum 1.5 g) IM given 2-3 times weekly.
Adverse Effect :
Anaphylaxis, ototoxicity, nephrotoxicity, rash, aplastic anemia.
Interaction :
Furosemide: Increase the toxicity of each other by pharmacodynamic synergism.
Quinidine: Increases the effect of streptomycin by P- glycoprotein.
Rocuronium: Increases the effect by pharmacodynamic synergism.
Torsemide: Increases the of each other by pharmacodynamic synergism.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Give every 24–72 hours. Dose according to levels |
| 10-20 | Give every 24–72 hours. Dose according to levels |
| <10 | Give every 72–96 hours. Dose according to levels |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Dialysed. Dose as in GFR<10 mL/ min |
| HD | Dialysed. Dose as in GFR<10 mL/ min |
| HDF/High flux | Dialysed. Dose as in GFR<10 mL/ min |
| CAV/VVHD | Dialysed. Dose as in GFR=10– 20 mL/min |
Hepatic Dose :
No dose adjustment recommended. Use cautiously in patients with cirrhosis or severe hepatic disease as hepatorenal syndrome may be precipitated.