Adult Dosing
Tuberculosis
- 15 mg/kg IM q24 hrs 5-7 times/wk. Max: 1 g/dose
- Alt: 25-30 mg/kg IM 2-3 times/wk. Max: 1.5 g/dose
- Decrease dose gradually after 2-4 months or after culture conversion. Duration of therapy: Minimum 1 yr
Plague
- 1 g IM q12 hrs x 10 days
- Max: 2 g/day
Tularemia
- 1 g IM q12 hrs x 7-14 days until the patient is afebrile for 5-7 days
Bacterial infections
- 1-2 g/day IM divided q6-12 hrs
- Max: 2 g/day
Moderate to severe infections; concomitant use with other agents
- 1-2 g/day IM divided q6-12 hrs
- Max: 2 g/day
Pharyngitis (Acute) [Non-FDA Approved]
- 1 g IM q12 hrs x 7-14 days until the patient is afebrile for 5-7 days
Pediatric Dosing
Tuberculosis
- 20-40 mg/kg IM q24 hrs. Max: 1 g/dose
- Alt: 20-40 mg/kg IM 2 times/wk. Max: 1 g/dose
Bacterial infections
- 20-40 mg/kg IM divided q6-12 hrs
- Max: 1 g/day
Pharyngitis (Acute) [Non-FDA Approved]
- 15 mg/kg IM q12 hrs [Max 1 gram/dose]
[Outline]
- Streptomycin can cause severe neurotoxicity and ototoxicity. The degree of impairment of vestibular and auditory function is proportional to the dose and duration of therapy, age of the patient, level of renal function and underlying existing auditory dysfunction
- Select dosage regimen carefully in patients with renal impairment. Risk of ototoxicity and neurotoxicity increases with renal impairment
- Do not exceed recommended dosage
- Streptomycin can cause fetal harm if administered to a pregnant woman. It crosses placental barrier and may cause ototoxicity in the fetus
- Stretomycin is for IM use only. Inject in a large muscle, preferred site is the upper outer quadrant of the buttock, (i.e., gluteus maximus), or the mid-lateral thigh
- Monitor BUN/Cr at baseline, then periodically
- Monitor serum drug levels; urinalysis; audiometry for high risk patients or if prolonged tx or if symptoms of hearing impairment
Cautions: Use cautiously in
- Renal impairment (blood level monitoring recommended due to risk of ototoxicity and nephrotoxicity)
- Neuromuscular disease (eg myasthenia gravis)
- Impaired vestibular function
- Impaired auditory function
- Concurrent ototoxic agents
- Concurrent neurotoxic agents
- Dehydration
- Concurrent nephrotoxic agents
- Electrolyte abnormalities
- Prolonged use
- Obese patients
- Neonates/infants
- Elderly pts
Pregnancy Category:D
Breastfeeding: Poorly excreted in breastmilk. Streptomycin would not be expected to adversely affect the breastfed infants. Monitor the infant for adverse effects such as diarrhea, candidiasis (e.g., thrush, diaper rash) or symptoms of antibiotic-associated colitis. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT). This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 last accessed 6 May 2010).
25 mcg/mL. Avoid concurrent and/or sequential nephrotoxic agents. Avoid concurrent potent diuretics
