Streptomycin

Drug #679

Streptomycin is an aminoglycoside antibiotic. It has a hexose ring, streptidine to which various amino sugars are attached by glycosidic linkages. Streptomycin is the first of the aminoglycoside antibiotic and was isolated from a strain of Streptomyces griseus by Waksman and his associates in 1944. Aminoglycoside frequently exibit synergism with a beta lactam antibiotc or vancomycin. In combination they eradicate organism more rapidly than a single agent. Aminoglycosides are polycations and their polarity accounts for their pharmakokinetic peopertie. Streptomycin is effective against a large variety of aerobic gram negative bacilli an some gram positive bacteria including mycobacteria. The use of Streptomycin is now limited because of the emergence of resistance. Antibiotics require constant drug level in body for therapeutic effect. This is achieved by taking the drug at regular intervals of time throughout the day and night as prescribed. Streptomycin is important to take the drug for the full time period as prescribed, discontinuation of the drug, may result in ineffective treatment.

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Primary Characteristics

It is of Semi Synthetic origin and belongs to Aminoglycosides.

It belongs to Antibacterial (Proetin synthesis inhibitor) pharmacological group on the basis of mechanism of action.

Molecular Weight: 581.6 · pK_a: 4.5 - 7.0 · Solubility in Water: highly · Solubility in Alcohol: Insoluble · Non-proprietary name: Streptomycin.

Pharmacokinetics

Absorption: Streptomycin has an oral bioavailability is 20% (±20%).

Distribution: Streptomycin has a volume of distribution is 96 l/kg. plasma protein binding is 33%.

Elimination: plasma half-life is 2.4 - 9.0 hr, renal excretion is 50 - 60%.

Indications

Streptomycin is primarily indicated in conditions like Bacterial infections, Oliguria due to renal failure, Plague, Tuberculosis, Tularemia.

Contraindications

Streptomycin is contraindicated in conditions like Myasthenia gravis, Renal diseases, Ear infection.

Dosage

Streptomycin's dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
15 mg/ kg	15 mg/ kg	Every 24h	IM	Maximum dose 1g/day
150 mg	150 mg	Every 24h	PO
Paediatric Dosage (20kg)
15 mg/kg	15 mg/kg	Every 12h	Intra Muscular	-
Neonatal Dosage (3kg)
15 mg/kg	15 mg/kg	Every 12h	Intra Muscular	-

Drug Interactions

Unknown5 interactions

9 interactions

Major2 interactions

Moderate1 interaction

Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Side Effects

Streptomycin in overdosage may give rise to further complications which include Deafness .

Streptomycin produces potentially life-threatening effects which include Agranulocytosis, Aplastic Anemia . Careful monitoring is needed with proper medical management.

The signs and symptoms that are produced after acute overdosage of Streptomycin are Hemolytic anemia, Renal failure.

Streptomycin is known to cause more or less tolerable side effects which are usually transient. These include Ataxia, Giddiness, Neck pain, Nystagmus , Pain , Pleocytosis, Tinnitus, Urinary retensionX, Vertigo.

Warnings / Precautions

Streptomycin should be used with caution in patients with history of kidney diseases, vertigo, hearing loss, myasthenia gravis, parkinsonisms. It should be used with caution in patients who are sensitive to aminoglycosides. Perform monthly blood counts test for atleast 4 months. Keep patients well hydrated to prevent chemical irritation or nephrotoxic reactions. Take appropriate measures in case of secondary infections.

Available Brands

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Single Ingredient

Inj

1 g

Multi-Ingredient Combinations

Inj

0.5 g 1 g

Storage Conditions

Streptomycin should be stored Inj.

Drug Classification

1.6.2.2.5 — Aminoglycosides
2.6.2.4 — Anti-tuberculosis drugs

Manufacturers

Manufacturers of Streptomycin in Pakistan:

PDH