Formulary
Streptomycin: Indications, Dosing, Side Effects and Interactions
Streptomycin clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Streptomycin: Indications, Dosing, Side Effects and Interactions
Streptomycin clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Tuberculosis, resistant to other treatment, in combination with other drugs**
- **Adult** (By Deep Intramuscular Injection): 15 mg/kg daily (max. per dose 1 g), reduce dose in those under 50 kg and those over 40 years.
**Adjunct to doxycycline in brucellosis (administered on expert advice)**
- **Adult** (By Deep Intramuscular Injection): (consult local protocol).
**Tuberculosis, resistant to other treatment, in combination with other drugs for streptomycin**
- **Child** (By deep intramuscular injection): 15 mg/kg once daily (max. per dose 1 g).
**Adjunct to doxycycline in brucellosis (administered on expert advice) for streptomycin**
- **Child** (By deep intramuscular injection): 5-10 mg/kg every 6 hours, total daily dose may alternatively be given in 2-3 divided doses.
Cautions
For all aminoglycosides (by injection) Auditory disorder; care must be taken with dosage (the main side-effects of the aminoglycosides are dose-related); conditions characterised by muscular weakness (aminoglycosides may impair neuromuscular transmission); if possible, dehydration should be corrected before starting an aminoglycoside; vestibular disorder; whenever possible, parenteral treatment should not exceed 7 days
Contraindications
For all aminoglycosides (by injection) Myasthenia gravis (aminoglycosides may impair neuromuscular transmission)
Side effects
For all aminoglycosides (by injection) Common or very common Aphonia; appetite decreased; bronchospasm; chest discomfort; cough; diarrhoea; dizziness; dysphonia; fever; haemoptysis; headache; hearing impairment; increased risk of infection; nausea; oropharyngeal pain; renal impairment; skin reactions; taste altered; tinnitus; vomiting Rare or very rare Anaemia; azotaemia; eosinophilia; hypomagnesaemia; paraesthesia Frequency not known Confusion; lethargy; leucopenia; muscle weakness; nephrotoxicity; peripheral neuropathy; thrombocytopenia; vertigo Side-effects, further information Ototoxicity and nephrotoxicity are important side-effects to consider with aminoglycoside therapy. Nephrotoxicity occurs most commonly in patients with renal impairment, who may require reduced doses; monitoring is particularly important in the elderly. Side-effects For streptomycin Frequency not known Amblyopia; angioedema; Clostridioides difficile colitis; haemolytic anaemia; ototoxicity; pancytopenia
Interactions
**Other interactions (1):**
- Simultaneous administration of other antituberculous drugs which also have ototoxic and nephrotoxic potential (e.g.
Pregnancy
For all aminoglycosides (by injection) There is a risk of auditory or vestibular nerve damage in the infant when aminoglycosides are used in the second and third trimesters of pregnancy. The risk is greatest with streptomycin. The risk is probably very small with gentamicin and tobramycin, but their use should be avoided unless essential. Monitoring in pregnancy If given during pregnancy, serum-aminoglycoside concentration monitoring is essential.
Renal impairment
For all aminoglycosides (by injection) Aminoglycosides are primarily renally excreted and accumulation can occur in renal impairment (increased risk of ototoxicity and nephrotoxicity)-serum-aminoglycoside concentrations must be frequently monitored in patients with renal impairment. M Dose adjustments Reduce dose and/or increase the dose interval according to impairment (consult product literature). M
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**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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