Streptomycin

Streptomycin – the aminoglikozidny antibacterial drug used for treatment of tuberculosis and some other diseases.

Pharmacological effect of Streptomycin

Active component of Streptomycin which is formed of radiant mushrooms of Streptomyces globisporus has bacteriostatic action.

The antibiotic Streptomycin possesses a broad spectrum of activity, in particular, it is active in the relation:

• Streptococcus spp., including Enterococcus spp. and Streptococcus pneumoniae;
• Mycobacterium tuberculosis;
• Some gram-positive microorganisms, including Staphylococcus spp.;
• Majority of gram-negative bacteria: Yersinia pestis, Salmonella spp., Neisseria meningitidis, Escherichia coli, Francisella tularensis, Klebsiella spp., Yersinia spp., Brucella spp., Shigella spp., Neisseria gonorrhoeae, Klebsiella pneumoniae, Haemophilus influenzae.

Use of Streptomycin is effective at treatment of an endocarditis which causes Enterococcus faecalis or Streptococcus of the viridans group (in a combination therapy with Vancomycinum or penicillin).

Streptomycin according to the instruction does not show activity concerning anaerobic bacteria of Rickettsia spp., Spirochaetaceae, Pseudomonas aeruginosa, Proteus spp.

Release form

Streptomycin is produced in the form of porous white powder for preparation of solution for intramuscular introduction on 250 mg, 500 mg and 1 g.

The closest analog of Streptomycin is the drug Pasomycinum.

Indications to Streptomycin use

According to the instruction Streptomycin is appointed at treatment:

• Endocarditis (in a combination with ampicillin);
• Tuberculosis of various localization, including tubercular meningitis;
• Tularemias;
• Venereal granuloma;
• Brucellosis;
• Intestinal infections, and also infections of urinary tract (in cases of sensitivity of the activator);
• Plagues.

Contraindications

Use of Streptomycin is contraindicated in the following cases:

• At hypersensitivity to active component of drug, and also to aminoglycosides in the anamnesis;
• At organic lesions of the VIII couple of cranial nerves;
• In cases if the disease develops against the background of a serious chronic illness of kidneys with an azotemia and uraemia;
• At pregnancy, except cases in which the advantage of use of Streptomycin justifies possible risk.

Streptomycin according to the instruction is appointed with care:

• At a myasthenia;
• At parkinsonism;
• At a disease of botulism (to avoid disturbances of neuromuscular transmission and further weakening of skeletal muscles);
• In the period of a lactation;
• At chronic heart failure, especially II-III severity;
• At an obliterating endarteritis;
• Dehydrations;
• At disturbance of cerebral circulation;
• At children's and advanced age;
• At a chronic renal failure;
• At tendency to bleeding.

Streptomycin route of administration

The antibiotic Streptomycin is applied intratrakhealno, intramusculary, in the form of aerosols, and also inside (in cases of treatment of infections of digestive tract).

At intramuscular introduction Streptomycin appoint in a daily dosage 1-2 g, and in cases of bad portability, weighing up to 50 kg and to elderly people – on 750 mg.

The daily dosage to children is calculated proceeding from body weight:

• Up to 3 months – on 10 mg/kg;
• 3-6 months – on 15 mg/kg;
• From 6 months to 2 years – on 20 mg/kg;
• From 2 to 13 years – on 15-20 mg/kg.

At treatment of not tubercular etiology Streptomycin is entered to four times a day. Streptomycin use duration – 7-10 days.

The daily dose of drug at treatment of tuberculosis should be entered in one step, but at bad portability Streptomycin use twice a day is allowed. Treatment duration – of three months.

By Intratrakhealno an antibiotic Streptomycin three times a week on 0,5-1 g appoint no more than three weekly. If the disease develops against the background of supertension and coronary heart disease, the initial dose is reduced to 250 mg a day, however at good tolerance it can be increased.

The therapy modes Streptomycin at a renal failure adjust depending on its expressiveness.

Side effects of Streptomycin

In certain cases at use of an antibiotic of Streptomycin there can be frustration of the alimentary system in the form of abnormal liver functions, vomiting, nausea and diarrhea.

Frustration from a nervous system are most often shown as:

• Headache;
• Peripheral neuritis;
• Drowsiness;
• Neuromuscular blockade – a night apnoea, difficulty or an apnoea (most often at introduction along with muscle relaxants);
• Weakness;
• Neurotoxic action in the form of twitching of muscles and epileptic seizures;
• Neuritis of a facial nerve in the form of paresthesias, burning sensation in a face or an oral cavity.

Besides, at use of Streptomycin can develop:

• Ototoxicity – a ring, decrease or a hearing loss (in rare instances – to irreversible deafness);
• Allergic reactions – a dermahemia, an itch, rash, fever, a Quincke's disease;
• Nephrotoxicity – a polyuria, nausea, a loss of appetite, an oliguria, thirst, vomiting. The probability of development of nephrotoxicity from use of Streptomycin increases at long administration of drug in high doses, and also at renal failures;
• Local reactions in the form of a hyperemia or pain in an injection site;
• Vestibular and labyrinth disturbances – dizziness, instability, a diskoordination.

At overdose toxic reactions in the form of thirst, dizziness, vomiting, a hearing loss, a loss of appetite, disturbance of breath, an ataxy, frustration of an urination, nausea arise Streptomycin.

At use of an antibiotic Streptomycin should be considered:

• Drug is incompatible with other ototoksichny and nefrotokschny medicines, including aminoglycosides and polymyxins;
• Streptomycin can reduce efficiency of therapy by anti-myasthenic drugs;
• Neuromuscular blockade is strengthened by the narcotic analgetics, galogensoderzhashchy hydrocarbons and other drugs blocking neuromuscular transmission;
• Indometacin (at intravenous administration) reduces renal clearance of Streptomycin;
• The risk of development of undesirable effects increases at simultaneous use with metoksiflurany.

Storage conditions

Streptomycin belongs to a number of antibacterial drugs of a prescription issue with a period of storage three years.