Streptomycin: Difference between revisions
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==General== | ==General== | ||
*Type: [[ | *Type: [[Is DrugClass::Aminoglycoside]] | ||
*Dosage Forms: | *Dosage Forms: | ||
**IM | **IM | ||
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===Infections, Bacterial=== | ===Infections, Bacterial=== | ||
*1-2 g/day IM divided q6-12h | *1-2 g/day IM divided q6-12h | ||
** Max: 2 g/day; Info: adjust dose based on serum levels | **Max: 2 g/day; Info: adjust dose based on serum levels | ||
**Renal dosing | **Renal dosing | ||
***Creatinine Clearance 50-80: give q24h | ***Creatinine Clearance 50-80: give q24h | ||
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***Creatinine Clearance <10: give q72-96h | ***Creatinine Clearance <10: give q72-96h | ||
===Active tuberculosis=== | ===Active [[tuberculosis]]=== | ||
* | *15mg/kg IM q24h 5-7x/wk | ||
**Alternative: 25- | **Alternative: 25-30mg/kg IM 2-3x/wk | ||
===Plague=== | ===[[Plague]]=== | ||
*1g IM q12h x10 days | *1g IM q12h x10 days | ||
**Maximum dose: 2 g/day (adjust dose based on serum levels) | **Maximum dose: 2 g/day (adjust dose based on serum levels) | ||
===Tularemia=== | ===[[Tularemia]]=== | ||
*1g IM q12h x10 days | *1g IM q12h x10 days | ||
**Maximum dose: 2 g/day (adjust dose based on serum levels) | **Maximum dose: 2 g/day (adjust dose based on serum levels) | ||
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===Infections, Bacterial=== | ===Infections, Bacterial=== | ||
*20- | *20-40mg/kg IM q24h | ||
**Alternative: 20- | **Alternative: 20-40mg/kg IM 2x/wk | ||
**Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk | **Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk | ||
**Renal dosing | **Renal dosing | ||
***Creatinine Clearance 50-80: 7. | ***Creatinine Clearance 50-80: 7.5mg/kg give q24h | ||
***Creatinine Clearance 10-50: 7. | ***Creatinine Clearance 10-50: 7.5mg/kg give q24-72h | ||
***Creatinine Clearance <10: 7. | ***Creatinine Clearance <10: 7.5mg/kg give q72-96h | ||
===Active tuberculosis=== | ===Active [[tuberculosis]]=== | ||
* 20- | *20-40mg/kg IM q24h | ||
**Alternative: 20- | **Alternative: 20-40mg/kg IM 2x/wk | ||
**Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk | **Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk | ||
===Plague=== | ===[[Plague]]=== | ||
* | *15mg/kg IM q12h x10 days | ||
**Maximum dose: 2 g/day (adjust dose based on serum levels) | **Maximum dose: 2 g/day (adjust dose based on serum levels) | ||
===[[Tularemia]]=== | |||
*15mg/kg IM q12h x10 days | |||
**Maximum dose: 2 g/day (adjust dose based on serum levels) | **Maximum dose: 2 g/day (adjust dose based on serum levels) | ||
== | ==Special Populations== | ||
* | *[[Pregnancy Rating]]: D | ||
*Lactation: Probably Safe | |||
*Monitoring parameters: | |||
**BUN/creatinine at baseline, then periodically. | |||
**Serum drug levels | |||
**Urinanalysis | |||
**Audiometry for high risk patients | |||
==Contraindications / | ==Contraindications / Cautions== | ||
*Contraindicated: | |||
**BCG live intravesical | |||
**[[Cidofovir]] | |||
**[[Streptozocin]] | |||
*caution if hypersensitivity to sulfites | *caution if hypersensitivity to sulfites | ||
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*caution in neonates or infants | *caution in neonates or infants | ||
*caution in elderly patients | *caution in elderly patients | ||
==Adverse Reactions== | |||
===Serious=== | |||
*Ototoxicity, auditory & vestibular | |||
*Neurotoxicity | |||
*Neuromuscular blockade | |||
*Nephrotoxicity | |||
*Anemia, hemolytic | |||
*Pancytopenia | |||
*[[Thrombocytopenia]] | |||
*[[Anaphylaxis]] | |||
*Angioedema | |||
*Hypersensitivity reaction | |||
*Exfoliative dermatitis | |||
*Superinfection | |||
===Common=== | |||
*[[Nausea and vomiting]] | |||
*[[Vertigo]] | |||
*Paresthesia, facial | |||
*[[Rash]] | |||
*[[Fever]] | |||
*[[Urticaria]] | |||
*[[Angioedema]] | |||
*Eosinophilia | |||
*Deafness | |||
*Exfoliative dermatitis | |||
*[[Anaphylaxis]] | |||
*Azotemia | |||
*Leukopenia | |||
*Thrombocytopenia | |||
*Pancytopenia | |||
*[[Anemia]], hemolytic | |||
*muscle weakness | |||
*Amblyopia | |||
*Injection site reaction | |||
==Pharmacology== | |||
*Half-life: 5 hours | |||
*Metabolism: Unknown; CYP450 | |||
*Excretion: Urine | |||
*Mechanism of Action: Bactericidal (binds to 30S ribosomal subunit, inhibiting protein synthesis) | |||
==See Also== | ==See Also== | ||
*[[Antibiotics (Main)]] | *[[Antibiotics (Main)]] | ||
== | ==References== | ||
<references/> | <references/> | ||
Epocrates | |||
[[Category: | [[Category:Pharmacology]] | ||
[[Category:ID]] | |||
Latest revision as of 15:12, 18 July 2025
General
- Type: Aminoglycoside
- Dosage Forms:
- IM
Adult Dosing
Infections, Bacterial
- 1-2 g/day IM divided q6-12h
- Max: 2 g/day; Info: adjust dose based on serum levels
- Renal dosing
- Creatinine Clearance 50-80: give q24h
- Creatinine Clearance 10-50: give q24-72h
- Creatinine Clearance <10: give q72-96h
Active tuberculosis
- 15mg/kg IM q24h 5-7x/wk
- Alternative: 25-30mg/kg IM 2-3x/wk
Plague
- 1g IM q12h x10 days
- Maximum dose: 2 g/day (adjust dose based on serum levels)
Tularemia
- 1g IM q12h x10 days
- Maximum dose: 2 g/day (adjust dose based on serum levels)
Pediatric Dosing
Infections, Bacterial
- 20-40mg/kg IM q24h
- Alternative: 20-40mg/kg IM 2x/wk
- Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk
- Renal dosing
- Creatinine Clearance 50-80: 7.5mg/kg give q24h
- Creatinine Clearance 10-50: 7.5mg/kg give q24-72h
- Creatinine Clearance <10: 7.5mg/kg give q72-96h
Active tuberculosis
- 20-40mg/kg IM q24h
- Alternative: 20-40mg/kg IM 2x/wk
- Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk
Plague
- 15mg/kg IM q12h x10 days
- Maximum dose: 2 g/day (adjust dose based on serum levels)
Tularemia
- 15mg/kg IM q12h x10 days
- Maximum dose: 2 g/day (adjust dose based on serum levels)
Special Populations
- Pregnancy Rating: D
- Lactation: Probably Safe
- Monitoring parameters:
- BUN/creatinine at baseline, then periodically.
- Serum drug levels
- Urinanalysis
- Audiometry for high risk patients
Contraindications / Cautions
- Contraindicated:
- BCG live intravesical
- Cidofovir
- Streptozocin
- caution if hypersensitivity to sulfites
- caution if impaired vestibular function
- caution if impaired auditory function
- caution if concurrent ototoxic agents
- caution if concurrent neurotoxic agents
- caution if neuromuscular disease
- caution if renal impairment
- caution if dehydration
- caution if concurrent nephrotoxic agent use
- caution if electrolyte abnormalities
- caution if prolonged use
- caution in neonates or infants
- caution in elderly patients
Adverse Reactions
Serious
- Ototoxicity, auditory & vestibular
- Neurotoxicity
- Neuromuscular blockade
- Nephrotoxicity
- Anemia, hemolytic
- Pancytopenia
- Thrombocytopenia
- Anaphylaxis
- Angioedema
- Hypersensitivity reaction
- Exfoliative dermatitis
- Superinfection
Common
- Nausea and vomiting
- Vertigo
- Paresthesia, facial
- Rash
- Fever
- Urticaria
- Angioedema
- Eosinophilia
- Deafness
- Exfoliative dermatitis
- Anaphylaxis
- Azotemia
- Leukopenia
- Thrombocytopenia
- Pancytopenia
- Anemia, hemolytic
- muscle weakness
- Amblyopia
- Injection site reaction
Pharmacology
- Half-life: 5 hours
- Metabolism: Unknown; CYP450
- Excretion: Urine
- Mechanism of Action: Bactericidal (binds to 30S ribosomal subunit, inhibiting protein synthesis)
See Also
References
Epocrates