Streptomycin: Difference between revisions

(Created page with "==General== *Type: Aminoglycosides *Dosage Forms: **IM ==Adult Dosing== ===Infections, Bacterial=== *1-2 g/day IM divided q6-12h ** Max: 2 g/day; Info: adjust dose base...")
 
(Replaced content with "==General== *Type: Aminoglycosides *Dosage Forms: **IM ==Adult Dosing== ===Infections, Bacterial=== *1-2 g/day IM divided q6-12h ** Max: 2 g/day; Info: adjust dose ...")
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==Pediatric Dosing==
==Pediatric Dosing==
'''All: Adjust repeat doses based on serum levels'''
===General (<7 Days Old)===
*'''<1.2kg'''
**15 mg/kg IV q24h
**First Dose: 15 mg/kg IV x 1
*'''1.2-2kg'''
**10-15 mg/kg IV q12-18h
**First Dose: 10-15 mg/kg IV x 1
*'''>2.1kg'''
**10-15 mg/kg IV q8-12h
**First Dose: 10-15 mg/kg IV x 1
===General (7 Days - 1 Month Old)===
*'''<1.2kg'''
**15 mg/kg IV q24h
**First Dose: 15 mg/kg IV x 1
*'''1.2-2kg'''
**10-15 mg/kg IV q8-12h
**First Dose: 10-15 mg/kg IV x 1
*'''>2.1kg'''
**15-20 mg/kg IV q8
**First Dose: 15-20 mg/kg IV x 1
===General (1 Month - 11 Years)===
*10-15 mg/kg IV q6-8h
*First Dose: 10-15 mg/kg IV x 1
*Max: 1 gram per dose
===General (12 - 16 Years)===
*1000 mg IV q12h
*First Dose: 1000mg IV x 1
*Alt: 10-15 mg/kg IV q12
*Info: Repeat dosing may require up to 1200-1500mg IV q12h or 10 mg/kg IV q8
===[[Clostridium Difficile]]===
*40 mg/kg/day PO divided q6-8h x 7-10 days
*First Dose: 10-13 mg/kg x 1
*Max 500mg/dose, 2000mg/day
*For severe infection or recurrence
*May use in combination with metronidazole PO
===Staphylococcal Enterocolitis===
*40 mg/kg/day PO divided q6-8h x 7-10 days
*First Dose: 10-13 mg/kg x 1
*Max 500mg/dose, 2000mg/day
===Community-Acquired [[Pneumonia (Peds)|Pneumonia]]===
*40 mg/kg/day PO divided q6-8h x 10-14 days
*First Dose: 10-13 mg/kg x 1
*Info: Switch to appropriate oral regiment when possible
==Special Populations==
*Pregnancy: C
*Lactation: Probably safe
*Renal Dosing
**Adult
***CrCl 50-90: 15mg/kg x1, then usual dose q12-24h
***CrCl 10-50: 15mg/kg x1, then usual dose q24h-96h
***CrCl <10: 15mg/kg x1, then usual dose q4-7 days
***Hemodialysis: Give supplement only if high-flux dialyzer used
***Peritoneal dialysis: No supplement
**Pediatric
***CrCl 10-50: give q18-48h
***CrCl <10: give q48-96h
***Hemodialysis: Give supplement only if high-flux dialyzer used
***Peritoneal dialysis: No supplement
*Hepatic Dosing (Adult & Pediatric)
**Not defined
==Contraindications==
*Allergy to class/drug
==Adverse Reactions==
===Serious===
*[[Anaphylaxis]]
*Severe [[hypotension]] (rapid IV use)
*Thrombophlebitis
*Tissue necrosis (if extravasation)
*vasculitis
*Exfoliative dermatitis
*[[Stevens-Johnson Syndrome]]
*[[Toxic Epidermal Necrolysis]]
*Drug rash with eosinophilia and systemic symptoms
*Interstitial nephritis
*Nephrotoxicity
*Ototoxicity
*Neutropenia
*[[Thrombocytopenia]]
*Superinfection
*[[Clostridium difficile]]
===Common===
*Red Man Syndrome (rapid IV use)
*Hypotension (rapid IV use)
*[[Fever]]
*[[Nausea]]
*rigors
*Eosinophilia
*[[Rash]]
*[[Urticaria]]
*Phlebitis
*Tinnitus
*[[Dizziness]]/[[Vertigo]]
*Elevated BUN/Creatinine
*[[Vomiting]] (PO use)
*Flatulence (PO use)
==Pharmacology==
*Half-life: 4-6h (7.5 days ESRD)
*Metabolism: CYP450
*Excretion:
**IV route: Urine
**PO Route: Minimal systemic absorption unless intestinal inflammation or renal impairment
*Mechanism of Action: Bactericidal
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||X1
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||'''S'''
|-
| ||[[Enterococcus faecium]]||I
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||'''S'''
|-
| ||[[CA-MRSA]]||'''S'''
|-
| ||[[Staph. Epidermidis]]||'''S'''
|-
| ||[[C. jeikeium]]||'''S'''
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||R
|-
| ||[[N. meningitidis]]||R
|-
| ||[[Moraxella catarrhalis]]||X1
|-
| ||[[H. influenzae]]||X1
|-
| ||[[E. coli]]||R
|-
| ||[[Klebsiella]] sp||R
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||X1
|-
| ||Serratia marcescens||R
|-
| ||[[Salmonella]] sp||R
|-
| ||[[Shigella]] sp||R
|-
| ||[[Proteus mirabilis]]||X1
|-
| ||[[Proteus vulgaris]]||R
|-
| ||[[Providencia sp.]]||X1
|-
| ||[[Morganella sp.]]||X1
|-
| ||[[Citrobacter freundii]]||X1
|-
| ||[[Citrobacter diversus]]||X1
|-
| ||[[Citrobacter sp.]]||X1
|-
| ||[[Aeromonas sp]]||X1
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||X1
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||R
|-
| ||[[Legionella sp.]]||X1
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||R
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||X1
|-
| ||[[Mycoplasm pneumoniae]]||X1
|-
| ||[[Rickettsia sp]]||R
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||'''S'''
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||R
|-
| ||[[Clostridium difficile]]||'''S'''
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==

Revision as of 22:58, 12 July 2014

General

Adult Dosing

Infections, Bacterial

  • 1-2 g/day IM divided q6-12h
    • Max: 2 g/day; Info: adjust dose based on serum levels

Active tuberclosis

  • 15 mg/kg IM q24h 5-7x/wk
    • Alternative: 25-30 mg/kg IM 2-3x/wk

Pediatric Dosing

See Also

Source

  • Epocrates
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