STREPTOMYCIN

 

INTRODUCTION:  Streptomycin was isolated from a strain of Streptomyces griseus. The antimicrobial activity of streptomycin is typical of that of other aminoglycosides, as are the mechanisms of resistance.  Resistance has emerged in most species, severely limiting the current usefulness of streptomycin. Ribosomal resistance to streptomycin develops readily, limiting its role as a single agent.

CLINICAL USES:  

A. Mycobacterial Infections; Streptomycin is mainly used as a second-line agent for treatment of tuberculosis. The dosage is 0.5–1 g/d (7.5–15 mg/kg/d for children), which is given intramuscularly or intravenously. It should be used only in combination with other agents to prevent emergence of resistance.

B. Non-tuberculous Infections:  In plague, tularemia, and sometimes brucellosis, streptomycin, 1 g/d (15 mg/kg/d for children), is given intramuscularly in combination with an oral tetracycline. Penicillin plus streptomycin is effective for enterococcal endocarditis and 2-week therapy of viridans streptococcal endocarditis. Gentamicin has largely replaced streptomycin for these indications.  Streptomycin remains a useful agent for treating enterococcal infections, however, because approximately 15% of enterococcal isolates that are resistant to gentamicin (and therefore resistant to netilmicin, tobramycin, and amikacin) will be susceptible to streptomycin.

ADVERSE REACTIONS:  Fever, skin rashes, and other allergic manifestations may result from hypersensitivity to streptomycin. This occurs most frequently with prolonged contact with the drug either in patients who receive a prolonged course of treatment (eg, for tuberculosis) or in medical personnel who handle the drug. Desensitization is occasionally successful. Pain at the injection site is common but usually not severe. The most serious toxic effect with streptomycin is disturbance of vestibular function; vertigo and loss of balance. The frequency and severity of this disturbance are in proportion to the age of the patient, the blood levels of the drug, and the duration of administration. Streptomycin given during pregnancy can cause deafness in the newborn and, therefore, is relatively contraindicated.

 

RELATED;

1.  TUBERCULOSIS

2. ANTITUBERCULAR DRUGS

3. BRUCELLOSIS

4. GENTAMYCIN

5. DRUG USE IN RELATION TO PREGNANCY

6. ANTIMICROBIAL DRUG RESISTANCE

REFERENCES