Streptomycin is an aminoglycoside antibiotic originally derived from the Streptomyces griseus bacterium. It was the first antibiotic discovered in this class and is mainly used to treat aerobic gram-negative bacterial infections, including brucellosis, tuberculosis, tularemia, and plague. This medication is typically prescribed alongside other drugs for active tuberculosis (TB), especially in cases where alternative TB treatments are ineffective or if the infection is drug-resistant.
Administration:
Since streptomycin is poorly absorbed in the gastrointestinal tract, it is administered via intramuscular injection as prescribed by a healthcare provider.
Dosage for Tuberculosis:
- Daily therapy: 15 mg/kg intramuscularly (IM) once daily, with a maximum dose of 1 g/day.
- Twice-weekly therapy: 25-30 mg/kg IM twice a week, not exceeding 1.5 g/day.
Warnings:
Streptomycin has the potential to cause serious nerve damage, which may lead to permanent hearing loss and balance issues. The risk increases in individuals with kidney disease, those receiving high doses or prolonged treatment, older adults (over 60 years), and those who are severely dehydrated. To minimize dehydration risk, patients should maintain adequate fluid intake unless advised otherwise by their doctor. It is essential to inform the healthcare provider of any pre-existing kidney or hearing conditions before starting treatment.
Adverse Effects:
- Cardiovascular: Low blood pressure (hypotension)
- Renal: Kidney toxicity (nephrotoxicity)
- Respiratory: Breathing difficulties
- Neurological: Nerve toxicity (neurotoxicity), drowsiness, tremors, headache, weakness
- Dermatological: Skin rash, eosinophilia
- Gastrointestinal: Nausea, vomiting
- Musculoskeletal: Joint pain (arthralgia)
Contraindications:
- Patients with renal impairment, as they may struggle to eliminate the drug efficiently.
- Pregnant women, due to streptomycin’s ability to cross the placenta and its potential ototoxic effects, making it teratogenic.
- Individuals with myasthenia gravis, as aminoglycosides can exacerbate the condition.
