|Streptomycin Sulphate B.P 2003 |
Each vial contains:
Streptomycin ( as sulphate ) 1.0 gm.
Streptomycin sulphate is an aminoglycoside bactericidal antibiotic. It acts by interfering with normal protein synthesis. It is active against some Gram-positive and many Gram-negative organisms.
Indications & usage:
Streptomycin sulphate is indicated for treatment of the following infections caused by susceptible strains of micro-organisms :
- Tuberculosis (caused by Mycobacterium tuberculosis): Streptomycin is added as a fourth drug in the regimen containing isoniazide, rifampine and pyrazinamide for initial treatment of tuberculosis or when one or more of these drugs is contraindicated .
- Non tuberculosis infections as :
- Plague (caused by Pasteurella pestis) .
- Malta fever (Brucellosis):Streptomycin is used in combination with doxycycline.
- Tularemia (caused by Francisella tularensis).
- Chancroid (caused by Haemophilus ducreyi).
- Respiratory, endocardial and meningeal infections (caused by Haemophilus influenzae).
- Klebsiella pneumoniae infection.
- Streptococcus veridans and Enterococcus faecalis in endocardial infections.
- Urinary tract infections caused by E.coli , Proteus spp., A.aerogenes and Enterococcus faecalis.
- Calymmatobacterium granulomatis (Donovanosis, granuloma inguinale).
Patients with myasthenia gravis.
Hypersensitivity to Streptomycin or other aminoglycoside.
Concomitant use of potentially ototoxic diuretics.
Concomitant use of general anesthetics or neuromuscular blockers.
Most adverse effects are dose related so care must be taken with dosage determination.
Hypersensitivity reactions (fever, rash, urticaria, angioneurotic edema and eosinophilia).
Reversible vestibular ototoxicity (nausea, vomiting and vertigo).
Paresthesia of the face.
Less frequent reactions include cochlear ototoxicity (hearing impairment or even deafness).
Rarely nephrotoxicity may occur especially in elderly and patients with renal failure.
Other neurotoxic reactions may occur as optic nerve dysfunction and peripheral neuritis.
Ototoxic effects may be potentiated by co-administration of furosemide, mannitol or possibly other diuretics. So, administration should be separated as long period as practicable .
Warnings & Precautions:
Audiometric tests and renal function test are advisable in case of extended streptomycin therapy.
Dosage regimen should be determined cautiously in case of renal insufficiency.
Nursing mothers: streptomycin can cause potential adverse reactions in infants. So, according to the importance of the drug to the mother determine whether to discontinue nursing or treatment with streptomycin.
Dosage & administration:
Adults: 15 mg/kg daily by deep IM injection (maximum 1 gm daily).
Children: 20 - 40 mg/kg/day (maximum 1 gm daily).
Dose should be reduced in patients under 50 kg, patients over 40 years or patients with renal impairment.
For non-tuberculous infections:
Generally, dose should not exceed 2 gm/day.
Adults: 1 – 2 gm daily in divided doses.
Children: 20 - 40 mg/kg/day.
* One Single dose vial .
* Hospital packing : Box of 100 vials .