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Medicine Overview of Streptomycin 1gm/vial Injection
বাংলা
English
Indication
Tuberculosis, Bacterial endocarditis, Plague, Tularaemia, Brucellosis
Administration
Reconstitution: Add 4.2 mL, 3.2 mL, or 1.8 mL of sterile water for inj to prepare a soln containing approx 200 mg, 250 mg, or 400 mg, respectively, of streptomycin per mL.
Adult Dose
Intramuscular Tuberculosis Adult: 15 mg/kg as a single dose daily. Max: 1 g daily. As part of intermittent regimen: 25-30 mg/kg 2-3 times wkly. Max: 1.5 g/dose. Bacterial endocarditis Adult: Streptococcal endocarditis: 1 g bid for 1 wk, then 500 mg bid for the 2nd wk. Enterococcal endocarditis: 1 g bid for 2 wk then 500 mg bid for 4 wk. Doses are given in combination w/ penicillin. Bacteraemia; Meningitis; Pneumonia ; Brucellosis; Urinary tract infections Adult: For concomitant use w/ other agents and as 2nd line agent: 1-2 g daily in divided doses 6-12 hrly. Max: 2 daily. Plague...
... Show moreChild Dose
Child: Moderate to Severe Infections: IM usually 20–30 mg/kg/day, max 1 g/day q12h Intramuscular Tuberculosis Child: 20-40 mg/kg as a single dose daily. Max: 1 g daily. As part of intermittent regimen: 25-30 mg/kg 2-3 times wkly. Max: 1.5 g/dose. Bacterial endocarditis Child: Enterococcal endocarditis: 20-30 mg/kg daily in 2 divided doses, in combination w/ penicillin. Bacteraemia; Meningitis; Pneumonia ; Brucellosis; Urinary tract infections Child: 20-40 mg/kg daily in divided doses 6-12 hrly. Plague Child: 30 mg/kg daily in 2-3 divided doses. Max: 2 g daily. Tularaemia Child: 15 mg/kg bid for at least 10-14 days. Max: 2 g daily....
... Show moreRenal Dose
Renal Impairment
Load: 1 g IM, THEN
CrCl: 50-80 mL/min: 7.5 mg/kg IM q24hr
CrCl: 10-50 mL/min: 7.5 mg/kg IM q24-72hr
CrCl <10 mL/min: 7.5 mg/kg IM q72-96hr
Hemodialysis: 50-75% of initial loading dose at end of dialysis period
Contraindication
Hypersensitivity to streptomycin and other aminoglycosides.
Mode of Action
Streptomycin is bactericidal which inhibits bacterial protein synthesis. Susceptible organisms include Mycobacterium tuberculosis, Pasteurella pestis, P.tularensis, Brucella, H.influenzae, H.ducreyi, Klebsiella pneumonia, Escherichia coli, Proteus spp., Aerobacter aerogenes, Streptococcus faecalis, and Streptococcus viridans.
Precaution
Patient w/ neuromuscular disorders (e.g. myasthenia gravis), pre-existing vertigo, or hearing loss. Renal impairment. Elderly, childn. Pregnancy and lactation. Monitoring Parameters Monitor renal and auditory function.
Side Effect
Neurotoxic reactions (e.g. vestibular and cochlear function disturbance, optic nerve dysfunction, peripheral neuritis, arachnoiditis, encephalopathy); paraesthesia of face, rash, fever, angioneurotic oedema, eosinophilia; exfoliative dermatitis, azotemia, leucopenia, thrombocytopenia, pancytopenia, haemolytic anaemia, muscular weakness, amblyopia.
Potentially Fatal: Resp paralysis from neuromuscular blockade, Clostridium difficile-associated diarrhoea, anaphylaxis; rarely, nephrotoxicity.
Interaction
H1-receptor blockers may mask early signs of ototoxicity. May reduce excretion of zalcitabine. May inhibit ?-galactosidase activity.
Potentially Fatal: Potentiates nephrotoxicity produced by other aminoglycosides, vancomycin and some cephalosporins. Potentiates ototoxicity produced by other aminoglycosides, ethacrynic acid, mannitol, furosemide and other diuretics.
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