Streptomycin: Difference between revisions

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==General==
==General==
*Type: [[Aminoglycosides]]
*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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===Active [[tuberculosis]]===
===Active [[tuberculosis]]===
*15 mg/kg IM q24h 5-7x/wk
*15mg/kg IM q24h 5-7x/wk
**Alternative: 25-30 mg/kg IM 2-3x/wk
**Alternative: 25-30mg/kg IM 2-3x/wk


===[[Plague]]===
===[[Plague]]===
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===Infections, Bacterial===
===Infections, Bacterial===
*20-40 mg/kg IM q24h
*20-40mg/kg IM q24h
**Alternative: 20-40 mg/kg IM 2x/wk
**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: 7.5 mg/kg give q24h
***Creatinine Clearance 50-80: 7.5mg/kg give q24h
***Creatinine Clearance 10-50: 7.5 mg/kg give q24-72h
***Creatinine Clearance 10-50: 7.5mg/kg give q24-72h
***Creatinine Clearance <10: 7.5 mg/kg give q72-96h
***Creatinine Clearance <10: 7.5mg/kg give q72-96h


===Active [[tuberculosis]]===
===Active [[tuberculosis]]===
* 20-40 mg/kg IM q24h
*20-40mg/kg IM q24h
**Alternative: 20-40 mg/kg IM 2x/wk
**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]]===
* 15 mg/kg IM q12h x10 days
*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]]===
===[[Tularemia]]===
* 15 mg/kg IM q12h x10 days
*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)


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*Lactation: Probably Safe
*Lactation: Probably Safe
*Monitoring parameters:
*Monitoring parameters:
**BUN/Cr at baseline, then periodically.
**BUN/creatinine at baseline, then periodically.
**Serum drug levels
**Serum drug levels
**Urinanalysis
**Urinanalysis
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*Anemia, hemolytic
*Anemia, hemolytic
*Pancytopenia
*Pancytopenia
*Thrombocytopenia
*[[Thrombocytopenia]]
*Anaphylaxis
*[[Anaphylaxis]]
*Angioedema
*Angioedema
*Hypersensitivity reaction
*Hypersensitivity reaction
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*[[Vertigo]]
*[[Vertigo]]
*Paresthesia, facial
*Paresthesia, facial
*Rash
*[[Rash]]
*Fever
*[[Fever]]
*Urticaria
*[[Urticaria]]
*[[Angioedema]]
*[[Angioedema]]
*Eosinophilia
*Eosinophilia
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*Thrombocytopenia
*Thrombocytopenia
*Pancytopenia
*Pancytopenia
*Anemia, hemolytic
*[[Anemia]], hemolytic
*muscle weakness
*muscle weakness
*Amblyopia
*Amblyopia
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*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
<references/>
Epocrates
Epocrates


[[Category:Drugs]]
[[Category:Pharmacology]]
[[Category:ID]]

Latest revision as of 15:12, 18 July 2025

General

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

  • 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

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

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