Streptomycin
- Atc Codes:A07AA04#J01GA01
- CAS Codes:3810-74-0#57-92-1
- PHARMGKB ID:3810-74-0#57-92-1
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Czech Republic: Strepto-Fatol; France: Streptomycine; Germany: Strepto-Fatol, StreptoHefa, Streptomycin; Greece: Streptomycin; Italy: Strep S; Latvia: Streptomycin; Lithuania: Streptomycin; Poland: Streptomycinum; Portugal: Estreptomicina; Romania: Strevital; Spain: Estreptomicina.
North America
USA: Streptomycin Sulphate.
Latin America
Argentina: Estreptomicina; Mexico: Bucomicina, Estrefén, Sulfestrep.
Asia
Japan: Streptomycin.
Drug combinations
Streptomycin and Neomycin
Streptomycin, Nitrofurazone, and Tyrothricin
Streptomycin, Clotrimazole, Nitrofurazone, and Tyrothricin
Chemistry
Streptomycin Sulfate: (C~21~H~39~N~7~O~12~)~2~ 3H~2~SO~4~. Mw: 1457.38. D-Streptamine, O-2-deoxy-2-(methylamino)-α-L-glucopyranosyl-(1→2)-O-5-deoxy-3-C-formyl-α-L-lyxofuranosyl-(1→4)-N,N’-bis(aminoiminomethyl)-, sulfate (2:3). CAS-3810-74-0; CAS-57-92-1 (streptomycin).
Pharmacologic Category
Antibacterials; Aminoglycosides. Antituberculosis Agents. (ATC-Code: A07AA04; J01GA01).
Mechanism of action
Usually bactericidal. Inhibits protein synthesis in susceptible bacteria by irreversibly binding to 30S ribosomal subunits. Active in vitro against Gram-positive aerobes such as Erysipelothrix, Enterococcus faecalis, Nocardia, and Streptococcus viridans. Active in vitro and in clinical infections against Gram-negative aerobes such as Brucella, Enterobacter aerogenes, Escherichia coli, Francisella tularensis, Haemophilus ducreyi, H. influenzae, Klebsiella granulomatis (formerly Calymmatobacterium granulomatis), Klebsiella pneumoniae, Pasteurella multocida, Proteus, and Yersinia pestis. Active against mycobacteria such as Mycobacterium tuberculosis, M. bovis, M. genavense, and some strains of M. avium complex, M. kansasii, M. malmoense, M. marinum, M. szulgai, and M. ulcerans. Partial cross-resistance occurs between streptomycin and other aminoglycosides. Inactive against fungi, viruses, and most anaerobic bacteria.
Therapeutic use
Active tuberculosis. Streptococcal or enterococcal endocarditis, mycobacterial infections, plague, tularemia, and brucellosis.
Pregnancy and lactiation implications
Streptomycin crosses placenta. Many case reports published of hearing impairment in children exposed in utero. Enters breast milk (not recommended in nursing women).
Unlabeled use
Contraindications
Hypersensitivity to streptomycin or any component of the formulation. Pregnancy.
Warnings and precautions
May cause nephrotoxicity. May cause neuromuscular blockade and respiratory paralysis. May cause neurotoxicity. Ototoxicity proportional to amount of drug given and duration of treatment. Tinnitus or vertigo may be indications of vestibular injury and impending bilateral irreversible damage. Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Parenteral form should be used only where appropriate audiometric and laboratory testing facilities are available. False-positive urine glucose with Benedict’s solution. Penicillin may decrease aminoglycoside serum concentrations in vitro.