Streptomycin

These indications are based on manufacturer information for both originator and generic products. For product specific registered indications, please refer to product specific manufacturer information

Registered South African indications:

• M.tuberculosis infections, infections of the urinary tract, bacterial meningitis, tularaemia, endocarditis, bonchitis, plague, brucellosis, peritonitis

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients

Caution

• Pregnancy
• Breastfeeding
• Moderate to severe renal impairment
• Elderly
• Patients with pre-existing vertigo, tinnitus, or hearing loss
• Patients with neuromuscular disorders

Forms avail. in SA and covered in this monograph: inj

Infections caused by Gram-positive aerobic cocci (including, Streptococci, Enterococci); Gram-negative aerobic bacilli (including, E.coli, Proteus spp., Klebsiella spp., H. influenza, Shigella, Salmonella, P. pestis, P. tularensis); Others, including: Mycobacterium tuberculosis

General dosing range

• IM: 8-35mg/kg/day, 6-24hrly OR 0.5-2.5g/day, 6-24hrly

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Brucellosis (additional agent required)

• IM: 1g, dly in 2-4 divided doses; Treatment duration: 14- 21 days

Endocarditis

- Enterococcal (additional agent required)

• IM: 1g, 12hrly for 2 weeks; THEN 500mg, 12hrly; Treatment duration: 4 weeks

- Streptococcal (additional agent required)

• IM: 1g, 12hrly for 1 week; THEN 500mg, 12hrly; Treatment duration: 1 week

Plague

• IM: 1g, 12hrly; Treatment duration: 10 days

Tuberculosis

• IM: 15mg/kg, dly; Max: 1g/24hrs

OR

- Directly observed therapy (DOT)

• IM: 25-30mg/kg, 2-3 times weekly; Max: 1.5g

Tularemia

• IM: 1-2g/day in 2 divided doses; Treatment duration: 7-14 days

Paed. forms avail. in SA and covered in this monograph: inj

Infections caused by Gram-positive aerobic cocci (including, Streptococci, Enterococci); Gram-negative aerobic bacilli (including, E.coli, Proteus spp., Klebsiella spp., H. influenza, Shigella, Salmonella, P. pestis, P. tularensis); Others, including: Mycobacterium tuberculosis

General dosing range

0-3 months

• IM: 10mg/kg/day, 6-8hrly

Between 3-12 months

• IM: 20-30mg/kg/day, 6-8hrly

Between 1-12 years

• IM: 20-30mg/kg/day, 8-12hrly

Older than 12 years

• See adult dosage

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Tuberculosis

• IM: 20-40mg/kg/day; Max: 1g/24hrs

OR

Directly observed therapy

• IM: 25-30mg/kg, 2-3 times weekly; Max: 1.5g

Pregnancy

• Caution; positive evidence of risk
• Teratogenicity has been observed with the use of streptomycin during pregnancy. Streptomycin crosses the placenta and should not be considered for first-line treatment of tuberculosis in pregnant women

Breastfeeding

• Caution
• Streptomycin is present in breast milk, following systemic administration. Breastfeeding is not recommended in mothers administered with streptomycin. Therefore the benefit of breastfeeding to the infant and the benefit of treatment to the mother should be weighed to make a decision on whether to discontinue breastfeeding or treatment to the mother

Renal Impairment

• Moderate to severe: Caution, dose adjustment recommended
• Dose adjustment must be calculated according to the patient's documented renal function (eGFR and CrCl) and the streptomycin plasma "trough" concentration levels

Hepatic Impairment

• No dose adjustment recommended

Elderly

• Caution; dose adjustment recommended

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warning

Central Nervous System Disorders

• Headache
• Ataxia
• Vertigo
• Neurotoxicity
• Peripheral neuritis
• Arachnoiditis
• Encephalopathy
• Neuromuscular disorders

Respiratory Disorders

• Respiratory paralysis

Gastrointestinal Disorders

• Nausea

Genitourinary Disorders

• Renal impairment

Sensory Disorders

• Tinnitis
• Disturbances of vestibular and cochlear function
• Optic nerve dysfunction
• Hearing impairment

• Bacitracin
• Colistimethate
• Foscarnet
• Mannitol
• Mecamylamine
• Methoxyflurane
• Penicillins
• Sodium picosulfate

• Audiometry
• Renal function

Streptomycin is an aminoglycoside antibiotic that works by binding to the bacterial 30S ribosomal subunit, causing misreading of t-RNA, leaving the bacterium unable to synthesize proteins vital to its growth. 

Spectrum of activity: Gram-positive aerobic cocci (including, Streptococci, Enterococci); Gram-negative aerobic bacilli (including, E.coli, Proteus spp., Klebsiella spp., H. influenza, Shigella, Salmonella, P. pestis, P. tularensis); Others, including: Mycobacterium tuberculosis

Injection (per 3ml) 1g

• Bio-Strep (Biotech)

Injection (per 15ml) 5g

• Bio-Strep (Biotech)
• Solustrep (Caps Pharma)