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STREPTOMYCIN
CASRN: 57-92-1
For other data, click on the Table of Contents
Human Health Effects:
Human Toxicity Excerpts:
The incidence of vestibular toxicity is particularly high in patients receiving
streptomycin; nearly 20% of individuals who received 500 mg twice daily for 4 weeks
for enterococcal endocarditis developed clinically detectable, irreversible vestibular
damage. In addition, up to 75% of patients who received 2 g of streptomycin for more
than 60 days showed evidence of nystagmus or postural imbalance.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1105]**PEER REVIEWED**
The administration of streptomycin in particular may produce dysfunction of the optic
nerve. Scotomas, presenting as enlargement of the blind spot, have been associated with
the drug. Among the less common toxic reactions to streptomycin is peripheral neuritis.
...
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1107]**PEER REVIEWED**
CNS depression characterized by stupor and flaccidity, and in some cases, coma and
respiratory depression, has been reported in infants receiving high doses of
streptomycin. Optic neuritis with blurred vision, visual disturbances, scotomas, and
enlargement of the blind spot have also been reported with aminoglycoside therapy.
[McEvoy, G.K. (ed.). American Hospital Formulary Service--Drug Information 94.
Bethesda, MD: American Society of Hospital Pharmacists, Inc. 1994 (Plus Supplements).
57]**PEER REVIEWED**
TOXIC EFFECTS ON VISION...HAVE BEEN RARE, BUT SEVERAL INSTANCES
HAVE BEEN REPORTED. IN A FEW CASES LONG-CONTINUED
ADMIN...CAUSED TEMPORARY VISUAL DISTURBANCES SUCH AS
XANTHOPSIA WITH CENTRAL SCOTOMA FOR BLUE, & NERVE FIBER
BUNDLE SCOTOMAS. ...INJECTION INTO THE VITREOUS...RAPIDLY
PRODUCE/S/ RETINAL EDEMA & SUBSEQUENT CLUMPING OF PIGMENT
WITH LOSS OF CELLULAR ELEMENTS OF THE RETINA, & MIGRATION OF
PIGMENT FROM PIGMENT EPITHELIUM.
[Grant, W.M. Toxicology of the Eye. 3rd ed. Springfield, IL: Charles C. Thomas
Publisher, 1986. 849]**PEER REVIEWED**
Among the less common toxic reactions to streptomycin is peripheral neuritis. This may
be due either to accidental injection of a nerve during the course of parenteral therapy or
to toxicity involving nerves remote from the site of antibiotic administration. Paresthesia,
most commonly perioral but also present in other areas of the face or in the hands,
occasionally follows the use of the antibiotic and usually appears within 30 to 60 minutes
after injection of the drug; it may persist for several hours.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1108]**PEER REVIEWED**
Eight members of a large kindred of mixed ancestry from a remote rural area of South
Africa were investigated for deafness. In each, severe permanent perceptive hearing loss
had developed during antituberculous therapy with streptomycin sulfate in conventional
doses. Although unproven by the data avail in this study, the familial aggregation and
pattern of distribution of sensitivity to streptomycin suggested autosomal dominant
inheritance.
[Viljoen DL et al; Familial aggregation of streptomycin ototoxicity: autosomal dominant
inheritance? J Med Genet 20 (5): 357-60 (1983)]**PEER REVIEWED**
Nephrotoxicity, as demonstrated by a significant rise in serum creatinine concentration,
occurs in from 5 to 20% of adult patients finishing a therapeutic course of an
aminoglycoside. Estimates of the risk of nephrotoxicity vary considerably. Differences in
the reported incidence among these studies are due to such factors as the variability in the
doses used, the vigor of the drug monitoring, and the ages of the patients studied. All
aminoglycosides have some potential for nephrotoxicity, even with careful therapeutic
drug monitoring. /Aminoglycosides/
[Haddad, L.M., Clinical Management of Poisoning and Drug Overdose. 2nd ed.
Philadelphia, PA: W.B. Saunders Co., 1990. 942]**PEER REVIEWED**
Neuromuscular blockade is a rare but potentially life-threatening toxicity as it can affect
the muscles of respiration. The aminoglycosides are the agents most frequently associated
with this side effect. In the presence of very high concentrations of aminoglycoside at the
neuromuscular junction, there is interference with neuromuscular transmission, resulting
in the potential for paralysis and respiratory arrest. Excessive serum concentrations can
occur during rapid intravenous administration. This side effect also has been described
after instillation of an aminoglycoside in high concentration directly into the pleural or
peritoneal spaces. /Aminoglycosides/
[Haddad, L.M., Clinical Management of Poisoning and Drug Overdose. 2nd ed.
Philadelphia, PA: W.B. Saunders Co., 1990. 935]**PEER REVIEWED**
When used for the treatment of plague, streptomycin may be so rapidly bactericidal that
it occasionally precipitates a Herxheimer-like reaction, which can be fatal.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 1496]**PEER REVIEWED**
Streptomycin is usually injected IM. Injection should be deep into the muscle, because
pain and sterile abscesses have developed with more superficial injection. The
intrapleural or intrathecal route of administration is rarely, if ever, employed. The latter
route has produced radiculitis, transverse myelitis, arachnoiditis, nerve root pain, and
even paraplegia.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 1497]**PEER REVIEWED**
Streptomycin causes hypersensitivity reactions ranging from skin rashes (fairly
common) to exfoliative dermatitis and anaphylactic shock. Hematopoietic reactions
(leukopenia, thrombocytopenia, pancytopenia, hemolytic anemia) have been reported.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 1497]**PEER REVIEWED**
Drug Warnings:
...CONTRAINDICATED IN PT WITH A HISTORY OF TOXICITY OR
HYPERSENSITIVITY TO THE DRUG OR WITH LABYRINTHINE DISEASE.
STREPTOMYCIN MUST BE USED WITH GREAT CAUTION, IF AT ALL,
DURING PREGNANCY, SINCE THE DRUG HAS CAUSED OTOTOXICITY IN THE
FETUS.
[American Hospital Formulary Service. Volumes I and II. Washington, DC: American
Society of Hospital Pharmacists, to 1984.,p. 8:12.28]**PEER REVIEWED**
Of 515 pt with tuberculosis who were treated with /streptomycin/, 8.2% had adverse
reactions; half of these involved the auditory and vestibular functions of the eighth
cranial nerve, and other relatively frequent problems incl rash (in 2%) and fever (in
1.4%).
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1154]**PEER REVIEWED**
...the elderly pt with streptococcal endocarditis due to a penicillin-sensitive strain should
probably receive penicillin alone, because of the incr toxicity from streptomycin in this
age group.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1108]**PEER REVIEWED**
Maternal Medication usually Compatible with Breast-Feeding: Streptomycin: Reported
Sign or Symptom in Infant or Effect on Lactation: None. /from Table 6/
[Report of the American Academy of Pediatrics Committee on Drugs in Pediatrics 93 (1):
142 (1994)]**PEER REVIEWED**
Pregnancy/Reproduction: Has been shown to cause deafness in humans.
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 69]**PEER REVIEWED**
Tuberculosis therapy may have to be continued for 1 to 2 years, and may even be
required for up to several years or indefinitely, although in some patients shorter
treatment regimens may also be effective. However, streptomycin should be
discontinued when toxicity or toxic symptoms appear or are impending, when organisms
have become resistant, or when the full therapeutic effect has been achieved.
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 69]**PEER REVIEWED**
Side/Adverse Effects: Those indicating need for medical attention: Incidence more
frequent: Nephrotoxicity (greatly increased or decreased frequency of urination or
amount of urine, increased thirst, loss of appetite, nausea, vomiting); neurotoxicity
(muscle twitching, numbness, seizures, tingling); ototoxicity auditory (and loss of
hearing, ringing or buzzing, a feeling of fullness in the ears); ototoxicity, vestibular
(clumsiness, dizziness, nausea, vomiting, unsteadiness); peripheral neuritis (burning of
face or mouth, numbness, tingling) - streptomycin only. Incidence less frequent:
Hypersensitivity (skin itching, redness, rash, or swelling); optic neuritis (any loss of
vision) - streptomycin only. Incidence rare: Neuromuscular blockade (difficulty in
breathing, drowsiness, weakness). /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 64]**PEER REVIEWED**
CNS depression, characterized by stupor, flaccidity, coma, or deep respiratory
depression, has been reported in very young infants receiving streptomycin at doses that
exceeded the maximum recommended amount. However, all aminoglycosides have this
potential to cause neuromuscular blockade. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
In general, the aminoglycosides have little allergenic potential; both anaphylaxis and rash
are unusual. Rare hypersensitivity reactions, including skin rashes, eosinophilia, fever,
blood dyscrasias, angioedema, exfoliative dermatitis, stomatitis, and anaphylactic shock,
have been reported. /Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1108]**PEER REVIEWED**
Because of their toxicity, aminoglycosides should be used with caution in elderly
patients, only after less toxic alternatives have been considered and/or found ineffective.
Elderly patients are more likely to have an age-related decrease in renal function.
Recommended doses should not be exceeded, and the patients's renal function should be
carefully monitored during therapy. Geriatric patients may require smaller daily doses of
aminoglycosides in accordance with their increased age, decreased renal function, and
possibly, decreased weight. In addition, loss of hearing may result even in patients with
normal renal function. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Since the incidence of nephrotoxicity and ototoxicity is related to the concentration to
which an aminoglycoside accumulates, it is critical to reduce the maintenance dosage of
these drugs in patients with impaired renal function. /Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1103]**PEER REVIEWED**
The administration of streptomycin in particular may produce dysfunction of the optic
nerve. Scotomas, presenting as enlargement of the blind spot, have been associated with
the drug.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1107]**PEER REVIEWED**
The topical application of streptomycin is contraindicated because of the high risk of
sensitization and rapidly developing bacterial resistance.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 1497]**PEER REVIEWED**
Teratogenicity has been documented in laboratory animals. This drug should not be
administered during the first trimester of pregnancy or in total doses exceeding 20 g
during the last half of pregnancy to minimize the possibility of congenital deafness.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 1647]**PEER REVIEWED**
Medical Surveillance:
An audiogram should be made when the job is expected to involve contact with
streptomycin... Immunological investigations can be carried out by direct skin tests with
suitable prepn /for epicutaneous test, 30% in liq paraffin and in vaseline 1:1; for
intradermal test, 0.5% physiological soln/. Patch and intradermal tests are used to study
skin reactivity; readings are made 20-30 min and 24-48 hr after application.
[International Labour Office. Encyclopedia of Occupational Health and Safety. Vols.
I&II. Geneva, Switzerland: International Labour Office, 1983. 172]**PEER
REVIEWED**
Emergency Medical Treatment:
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The following Overview, *** AMINOGLYCOSIDES ***, is relevant for this HSDB
record chemical.
Life Support:
o This overview assumes that basic life support measures
have been instituted.
Clinical Effects:
0.2.1 SUMMARY OF EXPOSURE
A) Overdose may result in renal damage and/or ototoxicity
depending on the administered dose, duration of therapy
with the excess dose and presence or absence of renal
dysfunction or other risk factors (elderly, dehydrated,
and patients receiving concomitant nephrotoxic agents).
0.2.4 HEENT
A) Irreversible damage to the auditory and vestibular
functions of the eighth cranial nerve may be noted.
Acute ischemic retinopathy has occurred from intraocular
administration of gentamicin.
0.2.10 GENITOURINARY
A) Nephrotoxicity appears to be completely reversible when
detected early and the drug is discontinued.
0.2.15 MUSCULOSKELETAL
A) Rapid injection of aminoglycosides may result in
neuromuscular blockade especially when given with other
neuromuscular blocking agents.
0.2.19 IMMUNOLOGIC
A) Hypersensitivity reactions have been reported most
frequently with neomycin, including skin rashes,
eosinophilia, fever, blood dyscrasias, angioedema,
exfoliative dermatitis, stomatitis, and anaphylaxis.
0.2.20 REPRODUCTIVE
A) Treatment of pregnant rat and guinea pig dams with
aminoglycosides resulted in functional and morphologic
renal damage in neonates.
B) Small amounts of aminoglycosides may be excreted into
breast milk, therefore it is recommended that the
aminoglycosides be administered with caution during
lactation due to the risk of adverse effects to the
infant.
Laboratory:
A) Monitor serum aminoglycoside concentration.
B) Monitor renal and eighth cranial nerve function
carefully. Obtain baseline serum creatinine and BUN in
all cases of suspected toxicity.
Treatment Overview:
0.4.2 ORAL/PARENTERAL EXPOSURE
A) ACTIVATED CHARCOAL: Administer charcoal as a slurry (240
mL water/30 g charcoal). Usual dose: 25 to 100 g in
adults/adolescents, 25 to 50 g in children (1 to 12
years), and 1 g/kg in infants less than 1 year old.
B) ALLERGIC REACTION: MILD/MODERATE: antihistamines with or
without inhaled beta agonists, corticosteroids or
epinephrine. SEVERE: oxygen, aggressive airway
management, antihistamines, epinephrine (ADULT: 0.3 to
0.5 mL of a 1:1000 solution subcutaneously; CHILD: 0.01
mL/kg, 0.5 ml max; may repeat in 20 to 30 min),
corticosteroids, ECG monitoring, and IV fluids.
C) Maintain good urine output (3 to 6 mL/kg/hr) with IV
fluids. This appears to be the treatment of choice
following acute single overdose in patients with normal
renal function.
D) DIALYSIS - hemodialysis is of questionable value
following overdose in patients with normal renal
function; dialysis should be considered in renal
failure.
E) COMPLEXATION WITH IV TICARCILLIN (2 to 5 grams every 4
to 6 hours) may be effective. There is little clinical
experience with this therapy and routine use is not
recommended.
Range of Toxicity:
A) GENTAMICIN - Toxicity (primarily nephrotoxicity) may
occur with persistent peak serum levels more than 12
mcg/mL and/or trough levels more than 2 mcg/mL.
B) AMIKACIN - Toxicity (primarily nephrotoxicity) may occur
with persistent peak serum levels more than 20 to 35
mcg/mL and trough levels more than 8 mcg/mL.
C) NEOMYCIN - Amounts present in ointments, otics or eye
products do not normally present a hazard to children or
adults.
1) However, deafness has been reported following
application of topical neomycin to preterm infants with
presumed cord infections and from instillation of an
otic solution to an elderly patient with a polyethylene
tube in place.
2) Ingestion of 2 g has produced deafness in an 18 month
old child.
ELATED DRUGS
[Rumack BH POISINDEX(R) Information System Micromedex, Inc., Englewood, CO,
2004; CCIS Volume 122, edition expires Nov, 2004. Hall AH & Rumack BH (Eds):
TOMES(R) Information System Micromedex, Inc., Englewood, CO, 2004; CCIS Volume
122, edition expires Nov, 2004.]**PEER REVIEWED**
Antidote and Emergency Treatment:
For most aminoglycoside overdosages, supportive symptomatic therapy, maintenance of
life support measures (airway, respiration, circulation), and administration of sufficient
fluids to maintain a urine flow of 3-6 ml/kg per hour are adequate. Caution must be
exercised to avoid fluid overload and pulmonary edema, especially when overaggressive
therapy is administered to patients with renal insufficiency. /Aminoglycosides/
[Ellenhorn, M.J. and D.G. Barceloux. Medical Toxicology - Diagnosis and Treatment of
Human Poisoning. New York, NY: Elsevier Science Publishing Co., Inc. 1988.
328]**PEER REVIEWED**
Emesis or gastric lavage may be useful. Activated charcoal and cathartics may be
effective; however, no systematic clinical studies of their efficacy are available.
/Aminoglycosides/
[Ellenhorn, M.J. and D.G. Barceloux. Medical Toxicology - Diagnosis and Treatment of
Human Poisoning. New York, NY: Elsevier Science Publishing Co., Inc. 1988.
329]**PEER REVIEWED**
There are no known antidotes for aminoglycoside overdosage. Calcium gluconate
intravenously may be useful in treatment of the neuromuscular paralysis.
/Aminoglycosides/
[Ellenhorn, M.J. and D.G. Barceloux. Medical Toxicology - Diagnosis and Treatment of
Human Poisoning. New York, NY: Elsevier Science Publishing Co., Inc. 1988.
329]**PEER REVIEWED**
Supportive measures to maintain fluid balance and adequate renal function are the
mainstays of treatment. Eighth cranial nerve function (auditory, vestibular) must be
carefully monitored in the period (weeks or months) after an aminoglycoside overdosage.
/Aminoglycosides/
[Ellenhorn, M.J. and D.G. Barceloux. Medical Toxicology - Diagnosis and Treatment of
Human Poisoning. New York, NY: Elsevier Science Publishing Co., Inc. 1988.
329]**PEER REVIEWED**
Animal Toxicity Studies:
Non-Human Toxicity Excerpts:
PHYTOTOXIC ON SOME FRUITS & ORNAMENTALS.
[Spencer, E. Y. Guide to the Chemicals Used in Crop Protection. 7th ed. Publication
1093. Research Institute, Agriculture Canada, Ottawa, Canada: Information Canada,
1982. 525]**PEER REVIEWED**
IV INJECTION OF STREPTOMYCIN (100-200 MG/LB) IN DOGS CAUSES AN
IRREVERSIBLE LOWERING OF SYSTEMIC ARTERIAL PRESSURE... RESP IS
PARALYZED BY LARGE IV DOSES (75 MG/LB)... PARESIS & DEPRESSION
APPEARED AFTER /YOUNG PIGS/...RECEIVED IM INJECTIONS OF...(100
MG/KG OF BODY WT). ALL PIGS DIED AFTER RECEIVING DOSES OF 175
MG/KG. CHICKENS & TURKEYS DEVELOP A SEVERE RESP DEPRESSION &
MAY BECOME COMATOSE. STREPTOMYCIN ADMIN IM IN FERRETS @ 170
& 250 MG/LB OF BODY WT PRODUCED LOSS OF CONSCIOUSNESS & DEATH.
[Jones, L.M., et al. Veterinary Pharmacology & Therapeutics. 4th ed. Ames: Iowa State
University Press, 1977. 945]**PEER REVIEWED**
THE CAT IS VERY SENSITIVE TO NEUROTOXIC EFFECTS OF
STREPTOMYCIN. A DAILY DOSE OF 25-75 MG/LB WILL PRODUCE
CHARACTERISTIC REACTIONS WITHIN AN AVG OF 20 DAYS. THESE
NEUROTOXIC EFFECTS INVOLVE POSTURE & GAIT, ATAXIA FIRST OF THE
HIND LEGS & THEN FRONT LEGS, & A PROGRESSIVE LOSS OF ROTATIONAL
NYSTAGMUS.
[Jones, L.M., et al. Veterinary Pharmacology & Therapeutics. 4th ed. Ames: Iowa State
University Press, 1977. 945]**PEER REVIEWED**
STREPTOMYCIN 20,000 UNITS/KG/DAY, IM INTO RATS 5-60 DAYS,
INHIBITED OXIDATIVE PHOSPHORYLATION IN BRAIN CEREBRUM &
CEREBELLUM, DECR OXYGEN UPTAKE IN CEREBELLUM, & INCR IT IN
CEREBRUM. A DECR IN ATP LEVEL & INCR IN PHOSPHOCREATINE LEVEL
WAS OBSERVED IN BOTH BRAIN AREAS.
[PRIEZZHEVA ON; CHANGES IN THE ENERGY-PRODUCING PROCESSES IN
THE REGIONS OF THE CENTRAL NERVOUS SYSTEM OCCURRING UNDER
THE EFFECT OF STREPTOMYCIN; FARMAKOL TOKSIKOL (MOSCOW) 36 (4):
414-7 (1973)]**PEER REVIEWED**
Streptomycin may produce acute signs of...nausea, vomiting /in cats and dogs/... Such
signs are most likely to occur following deliberate or accidental iv injection.
[Clarke, M. L., D. G. Harvey and D. J. Humphreys. Veterinary Toxicology. 2nd ed.
London: Bailliere Tindall, 1981. 102]**PEER REVIEWED**
/Investigators/...were unable to detect deafness in mice or rats exposed to 200 to 600
mg/kg during pregnancy. /Investigators/...gave 25 or 250 mg/kg to mice on the 14th
gestational day and detected growth failure for a mo after birth.
[Shepard, T. H. Catalog of Teratogenic Agents. 3rd ed. Baltimore, MD.: Johns Hopkins
University Press, 1980. 303]**PEER REVIEWED**
IN RABBITS WITH EXPTL TUBERCULOSIS, TREATMENT WITH
STREPTOMYCIN (20 MG/KG, IM) LOWERED THE SPONTANEOUS
ELECTRICAL ACTIVITY & REACTIVE CAPACITY OF THE CORTEX, AS
EVIDENCED BY THE NARROW AMPLITUDE OF THE MAIN RHYTHM, THE
COEFFICIENT AND ENERGY OF SYNCHRONIZATION ON RHYTHMIC
PHOTOSTIMULATION, AND THE PAROXYSMAL ACTIVITY WITHIN THE
THETA RANGE. THE EFFECT OF ANTIBACTERIAL TREATMENT APPEARED
TO BE DUE TO NEUROTROPIC ACTION.
[AKSELROD LB ET AL; EFFECT OF PROLONGED USE OF STREPTOMYCIN
AND STREPTOMYCIN COMBINED WITH TUBAZID ON BRAIN BIOELECTRIC
ACTIVITY IN ANIMALS WITH EXPERIMENTAL TUBERCULOSIS; ANTIBIOTIKI
(MOSCOW) 21 (7): 636-42 (1976)]**PEER REVIEWED**
Metabolism/Pharmacokinetics:
Absorption, Distribution & Excretion:
STREPTOMYCIN IS DISTRIBUTED INTO MOST BODY TISSUES & FLUIDS
EXCEPT THE BRAIN. SUBSTANTIAL AMOUNTS OF THE DRUG ARE FOUND IN
PLEURAL FLUID AND TUBERCULOSIS CAVITIES AND SMALL AMOUNTS
ARE EXCRETED IN SALIVA AND SWEAT.
[McEvoy, G.K. (ed.). American Hospital Formulary Service--Drug Information 94.
Bethesda, MD: American Society of Hospital Pharmacists, Inc. 1994 (Plus Supplements).
67]**PEER REVIEWED**
Because of their polar nature, the aminoglycosides are largely excluded from most cells,
from the central nervous system, and from the eye. Except for streptomycin, there is
negligible binding of aminoglycosides to plasma albumin. The apparent volume of
distribution of these drugs is 25% of lean body weight and approximates the volume of
extracellular fluid. /Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1102]**PEER REVIEWED**
As would be expected, concentrations of aminoglycosides in secretions and tissues are
low. High concentrations are found only in the renal cortex and in the endolymph and
perilymph of the inner ear; this may contribute to the nephrotoxicity and ototoxicity
caused by these drugs. Concentrations in the bile approach 30% of those found in plasma
as a result of active hepatic secretion, but this represents a very minor excretory route for
the aminoglycosides. Penetration into respiratory secretions is poor. Diffusion into
pleural and synovial fluid is relatively slow, but concentrations that approximate those in
the plasma may be achieved after repeated administration. Inflammation increases the
penetration of aminoglycosides into peritoneal and pericardial cavities.
/Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1102]**PEER REVIEWED**
Administration of aminoglycosides to women late in pregnancy may result in
accumulation of drug in fetal plasma and amniotic fluid. /Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1103]**PEER REVIEWED**
The aminoglycosides are excreted almost entirely by glomerular liberation, and
concentrations in the urine of 50 to 200 ug/ml are achieved. A large fraction of a
parenterally administered dose is excreted unchanged during the first 24 hours, with most
of this appearing in the first 12 hours. /Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1103]**PEER REVIEWED**
All of the aminoglycosides are absorbed rapidly from intramuscular sites of injection.
Peak concentrations in plasma occur after 30 to 90 minutes and are similar to those
observed 30 minutes after completion of an intravenous infusion of an equal dose over a
30 minute period. In critically ill patients, especially those in shock, absorption of drug
may be reduced from intramuscular sites because of poor perfusion. /Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1102]**PEER REVIEWED**
The aminoglycosides are highly polar cations; they are thus very poorly absorbed from
the gastrointestinal tract. Less than 1% of a dose is absorbed following either oral or
rectal administration. The drugs are not inactivated in the intestine, and they are
eliminated quantitatively in the feces. ... However, long-term oral or rectal administration
may result in accumulation of aminoglycosides to toxic concentrations is patients with
renal impairment. Instillation of these drugs into body cavities with serosal surfaces may
result in rapid absorption and unexpected toxicity. Similarly, intoxication my occur when
aminoglycosides are applied topically for long periods to large wounds, burns, or
cutaneous ulcers, particularity if there is renal insufficiency. /Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1102]**PEER REVIEWED**
Biological Half-Life:
The plasma elimination half-life of streptomycin is usually 2-3 hours in adults with
normal renal function and has been reported to range up to 110 hours in adults with
severe renal impairment. The plasma elimination half-life of streptomycin has been
reported to range from 4-10 hours in premature and newborn infants. In patients with
impaired hepatic and renal function, the plasma elimination half-life has been reported to
be more prolonged than in patients with renal impairment alone.
[McEvoy, G.K. (ed.). American Hospital Formulary Service--Drug Information 94.
Bethesda, MD: American Society of Hospital Pharmacists, Inc. 1994 (Plus Supplements).
67]**PEER REVIEWED**
The elimination half-life is about five hours; however, tissue-bound streptomycin may
be released slowly over many days.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 1647]**PEER REVIEWED**
Mechanism of Action:
The primary intracellular site of action of the aminoglycosides is the 30 S ribosomal
subunit, which consists of 21 proteins and a single 16 S molecule of RNA. at least three
of these proteins and perhaps the 16 S ribosomal RNA as well contribute to the
streptomycin binding site, and alterations of these molecules markedly affect the binding
and subsequent action of streptomycin. For example, a single amino acid substitution of
asparagine for lysine at position 42 of one ribosomal protein (S12) prevents binding of
the drug; the resultant mutant is totally resistant to streptomycin. Another mutant, in
which glutamine is the amino acid at this position, is dependent on streptomycin.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1100]**PEER REVIEWED**
STREPTOMYCIN DEPRESSED NEUROMUSCULAR TRANSMISSION IN THE
RAT SCIATIC NERVE GASTROCNEMIUS MUSCLE PREPN, BUT DID NOT
DEPRESS THE DIRECTLY-EVOKED TWITCH IN CHRONICALLY DENERVATED
GASTROCNEMIUS MUSCLE. IN THE ISOLATED SCIATIC NERVE,
STREPTOMYCIN DECR THE AMPLITUDE OF ACTION POTENTIALS.
STREPTOMYCIN ALSO SUPPRESSED POST-TETANIC POTENTIATION IN THE
NERVE-MUSCLE PREPN. STREPTOMYCIN INHIBITED MUSCLE
CONTRACTION INDUCED BY ACETYLCHOLINE. THUS, STREPTOMYCIN
MAY INHIBIT NEUROMUSCULAR TRANSMISSION BY COMPETING WITH
ACETYLCHOLINE FOR CHOLINERGIC RECEPTOR SITES, BY DECREASING
ENDPLATE SENSITIVITY, OR BY A PRESYNAPTIC ACTION BY INTERACTING
WITH CALCIUM.
[NASODE B, APISARIYAKUL A; STUDY OF THE MECHANISM OF ACTION OF
STREPTOMYCIN ON NEUROMUSCULAR TRANSMISSION; CHIANG MAI MED
BULL 16 (3): 113-6 (1977)]**PEER REVIEWED**
Streptomycin has a neuromuscular blocking effect and decreases indirectly stimulated
contractions of the gastrocnemius muscle in anaesthetized piglets and lambs ... .
[Humphreys, D.J. Veterinary Toxicology. 3rd ed. London, England: Bailliere Tindell,
1988. 103]**PEER REVIEWED**
Interactions:
NON-IONIC, ANIONIC, & ZWITTERIONIC SURFACTANTS INDUCED A
RAPIDLY REVERSIBLE HYPER-ABSORPTIVE STATE IN THOMAS CANINE
FUNDIC POUCH FOR...STREPTOMYCIN... IN THE PRESENCE OF
SURFACTANTS, BLOOD LEVELS OF /STREPTOMYCIN/...WERE MANY TIMES
GREATER THAN VALUES IN CONTROLS.
[The Chemical Society. Foreign Compound Metabolism in Mammals. Volume 2: A
Review of the Literature Published Between 1970 and 1971. London: The Chemical
Society, 1972. 417]**PEER REVIEWED**
STREPTOMYCIN SHOULD NOT BE GIVEN CONCURRENTLY WITH POTENT
DIURETICS SUCH AS ETHACRYNIC ACID...OR FUROSEMIDE...WHICH CAN
PRODUCE OTOTOXICITY & MAY ADD TO OR POTENTIATE THE
OTOTOXICITY OF STREPTOMYCIN. ... USE OF ANESTHETICS &
NEUROMUSCULAR BLOCKING AGENTS WITH STREPTOMYCIN CAN
POTENTIATE NEUROMUSCULAR BLOCKADE & CAUSE RESPIRATORY
PARALYSIS...
[American Hospital Formulary Service. Volumes I and II. Washington, DC: American
Society of Hospital Pharmacists, to 1984.,p. 8:12.28]**PEER REVIEWED**
The effect of calcium 4'-phosphopantothenate (CPP) on acute toxicity of streptomycin
and the decr by the antibiotic of the muscle working capacity, "holes" reflex, body temp
and oxygen intake were studied on 258 albino mice weighing 22-26 g. Medical calcium
pantothenate (CPA) was used for control purposes. CPP is an antagonist of streptomycin
sulfate. In a dose of 1/10 or 1/5 of the LD50 injected ip CPP lowered acute toxicity of
streptomycin and prevented its effect in a dose of 0.11-1.1 g/kg injected sc on the
muscle working capacity, "holes" reflex and body temp. CPA lowered the streptomycin
effect on the "holes" reflex and body temp, while CPP prevented it.
[Dorofeev BF et al; Alteration of the acute toxicity and various pharmacologic effects of
streptomycin sulfate by calcium 4'-phosphopantothenate; Antibiotiki 28 (10): 760-3
(1983)]**PEER REVIEWED**
Concurrent and/or sequential use of 2 or more aminoglycosides by any route or
concurrent use of capreomycin with aminoglycosides should be avoided since the
potential for ototoxicity, nephrotoxicity, and neuromuscular blockage may be increased;
hearing loss may occur and may progress to deafness even after discontinuation of the
drug; loss of hearing may be reversible, but usually is permanent; neuromuscular
blockade may result in skeletal muscle weakness and respiratory depression or paralysis
(apnea). Also, concurrent use of 2 or more aminoglycosides may result in reduced
bacterial uptake of each one since the medications compete for the same uptake
mechanism. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Aminoglycosides can be inactivated by many beta-lactam antibiotics (cephalosporins,
penicillins) in vitro and in vivo in patients with significant renal failure. Degradation
depends on the concentration of the beta-lactam, storage time, and temperature.
/Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
When aminoglycosides are administered concurrently with intravenous indomethacin in
the premature neonate, renal clearance of aminoglycosides may be decreased, leading to
increased plasma concentrations, elimination half-lives, and risk of aminoglycoside
toxicity; dosage adjustment of aminoglycosides based on measurement of plasma
concentrations and/or evidence of toxicity may also be required. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Concurrent and/or sequential use of /methoxyflurane or parenteral polymyxins/ with
aminoglycosides should be avoided since the potential for nephrotoxicity and/or
neuromuscular blockade may be increased; neuromuscular blockade may result in
skeletal muscle weakness and respiratory depression or paralysis (apnea); caution is also
recommended when methoxyflurane or polymyxins are used concurrently with
aminoglycosides during surgery or in the postoperative period. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Concurrent use of medications with neuromuscular blocking activity, including
halogenated hydrocarbon inhalation anesthetics, opioid analgesics, and massive
transfusions with citrate anticoagulated blood, with aminoglycosides should be carefully
,monitored since neuromuscular blockade may be enhanced, resulting in skeletal muscle
weakness and respiratory depression or paralysis (apnea); caution is recommended when
these medications and aminoglycosides are used concurrently during surgery or in the
postoperative period, especially if there is a possibility of incomplete reversal of
neuromuscular blockade postoperatively; treatment with anticholinesterase agents or
calcium slats may help reverse the blockade. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Many antibiotics (eg, streptomycin ...) enhance the neuromuscular block produced by
tubocurarine and other nondepolarizing agents.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 206]**PEER REVIEWED**
Streptomycin reportedly causes false-positive results in urine glucose determinations
using cupric sulfate solution (Benedict's reagnet, Clintest).
[McEvoy, G.K. (ed.). American Hospital Formulary Service--Drug Information 94.
Bethesda, MD: American Society of Hospital Pharmacists, Inc. 1994 (Plus Supplements).
58]**PEER REVIEWED**
Pharmacology:
Therapeutic Uses:
Antibiotics, Aminoglycoside; Antibiotics, Antitubercular; Protein Synthesis Inhibitors
[National Library of Medicine's Medical Subject Headings online file (MeSH,
1999)]**QC REVIEWED**
INVESTIGATIONALLY, STREPTOMYCIN HAS BEEN USED WITH SOME
SUCCESS IN THE TREATMENT OF BILATERAL MENIERE'S DISEASE.
[American Hospital Formulary Service. Volumes I and II. Washington, DC: American
Society of Hospital Pharmacists, to 1984.,p. 8:12.28]**PEER REVIEWED**
/SRP: Except in patients with significant renal failure/ streptomycin and penicillin
produce a synergistic bactericidal effect in vitro and in animal models of infection against
strains of enterococci, group-D streptococci, and the various oral streptococci of the
viridans group. Many authorities administer such antibiotics concurrently for treatment of
endocarditis caused by these microorganisms.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1108]**PEER REVIEWED**
Streptomycin was the first clinically effective drug to become available for the treatment
of tuberculosis. At first, it was given in large doses, but problems related to toxicity and
the development of resistant microorganisms seriously limited its usefulness. The
antibiotic was then administered in smaller quantities, but streptomycin administered
alone still proved to be far from the ideal agent for the management of all forms of the
disease. However, the discovery of other compounds that, given concurrently with the
antibiotic, reduced the rate at which microorganisms became drug resistant enabled
physicians to treat tuberculosis effectively with streptomycin. It is now the least used of
the "first-line" agents in the therapy of tuberculosis.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1153]**PEER REVIEWED**
Aminoglyocside are indicated in the treatment of serious systemic infections for which
less toxic antibacterials are ineffective or contraindicated. The spectrum of
aminoglycosides covers aerobic gram-negative bacilli, and some gram-positive
organisms. They are not active against anaerobic organisms. /Aminoglycosides; Included
in US product labeling/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 61]**PEER REVIEWED**
The antibacterial activity of aminoglycosides against different strains of organisms varies
among institutions and regions. However, aminoglycosides are generally active against
most Enterobacteriaceae, including Escherichia coli, Proteus mirabilis, indole-positive
Proteus, Citrobacter, Enterobacter, Klebsiella, Providencia, and Serratia species.
Acinetobacter and Pseudomonas species are also usually susceptible. Although
tobramycin is more potent in vitro against Pseudomonas aeruginosa, and gentamicin is
more potent in vitro against Serratia species, neither has been shown to be more clinically
effective than the other aminoglycosides if the organism is susceptible. Aminoglycosides
ar used concurrently with antipseudomonal penicillins or certain cephalosporins in the
treatment of serious Pseudomonas aeruginosa infections. /Aminoglycosides; Included in
US product labeling/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 61]**PEER REVIEWED**
Streptomycin is used primarily as an antitubercular and is active against Mycobacterium
tuberculosis and Mycobacterium bovis. it is also considered the drug of choice for the
treatment of infections caused by Francisella tularensis and Yersinia pestis, and is often
used to treat Brucella infections. Because many other gram-negative bacilli are resistant,
streptomycin is rarely used to treat those organisms. /Aminoglycosides; Included in US
product labeling/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 61]**PEER REVIEWED**
Aminoglycosides are also active against Staphylococcus aureus, but are rarely used as
sole therapy since other, less toxic, antibiotics are available. Amikacin, gentamicin,
netilmicin, or tobramycin, administered concurrently with a penicillin, is synergistic
against certain susceptible strains of Enterococcus faecalis. Streptomycin has been used,
in combination with penicillin or vancomycin, in the treatment of endocarditis caused by
Enterococcus faecalis or Staphylococcus viridans. /Aminoglycosides; Included in US
product labeling/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 61]**PEER REVIEWED**
Aminoglycosides are indicated for the treatment of serious infections caused by, or
strongly suspected to be caused by susceptible gram-negative bacilli. Some
aminoglycosides, such as amikacin, gentamicin, and tobramycin, amy also be given as an
aerosol nebulization. This is usually as an adjunct to parenteral therapy in patients with
cystic fibrosis with acute exacerbations of pulmonary infections. Aminoglycosides are
used to treat central nervous system infections mainly in neonates due to better
penetration across the blood-brain barrier in this age group; gentamicin may also be given
intrathecally to treat CNS infections in adults. Aminoglycosides are also used in
combination with other antibacterials for a possible synergistic effect. Among the
infections that aminoglycosides are used to treat are: biliary tract infections (treatment);
bone and joint infections (treatment); central nervous system infections (including
meningitis and ventriculitis) (treatment); intra-abdominal infections (including
peritonitis) (treatment); pneumonia, gram-negative, bacterial (treatment); septicemia,
bacterial (treatment); skin and soft tissue infections (including burn would infections)
(treatment); urinary tract infections (recurrent complicated ) (treatment).
/Aminoglycosides; Included in US product labeling/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 61]**PEER REVIEWED**
Streptomycin is used for the treatment of: brucellosis (treatment), granuloma inguinale
(treatment), plague (treatment), tuberculosis (treatment), tularemia (treatment).
/Aminoglycosides; Included in US product labeling/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 61]**PEER REVIEWED**
Patients with tularemia benefit dramatically from the administration of streptomycin.
The best results are obtained when therapy is instituted early; however, chronicity does
not exclude the possibility of complete cure. Most cases respond to the administration of
1 to 2 g of streptomycin per day for 7 to 10 days.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1108]**PEER REVIEWED**
Aminoglycosides are not indicated routinely in the treatment of staphylococcal infections
since less toxic antibacterials are available. Aminoglycosides are not routinely indicated
in the initial treatment of uncomplicated urinary tract infections unless the organism is
resistant to other less toxic antibacterials. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 61]**PEER REVIEWED**
MEDICATION (VET): ANTIBACTERIAL
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
Drug Warnings:
...CONTRAINDICATED IN PT WITH A HISTORY OF TOXICITY OR
HYPERSENSITIVITY TO THE DRUG OR WITH LABYRINTHINE DISEASE.
STREPTOMYCIN MUST BE USED WITH GREAT CAUTION, IF AT ALL,
DURING PREGNANCY, SINCE THE DRUG HAS CAUSED OTOTOXICITY IN THE
FETUS.
[American Hospital Formulary Service. Volumes I and II. Washington, DC: American
Society of Hospital Pharmacists, to 1984.,p. 8:12.28]**PEER REVIEWED**
Of 515 pt with tuberculosis who were treated with /streptomycin/, 8.2% had adverse
reactions; half of these involved the auditory and vestibular functions of the eighth
cranial nerve, and other relatively frequent problems incl rash (in 2%) and fever (in
1.4%).
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1154]**PEER REVIEWED**
...the elderly pt with streptococcal endocarditis due to a penicillin-sensitive strain should
probably receive penicillin alone, because of the incr toxicity from streptomycin in this
age group.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1108]**PEER REVIEWED**
Maternal Medication usually Compatible with Breast-Feeding: Streptomycin: Reported
Sign or Symptom in Infant or Effect on Lactation: None. /from Table 6/
[Report of the American Academy of Pediatrics Committee on Drugs in Pediatrics 93 (1):
142 (1994)]**PEER REVIEWED**
Pregnancy/Reproduction: Has been shown to cause deafness in humans.
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 69]**PEER REVIEWED**
Tuberculosis therapy may have to be continued for 1 to 2 years, and may even be
required for up to several years or indefinitely, although in some patients shorter
treatment regimens may also be effective. However, streptomycin should be
discontinued when toxicity or toxic symptoms appear or are impending, when organisms
have become resistant, or when the full therapeutic effect has been achieved.
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 69]**PEER REVIEWED**
Side/Adverse Effects: Those indicating need for medical attention: Incidence more
frequent: Nephrotoxicity (greatly increased or decreased frequency of urination or
amount of urine, increased thirst, loss of appetite, nausea, vomiting); neurotoxicity
(muscle twitching, numbness, seizures, tingling); ototoxicity auditory (and loss of
hearing, ringing or buzzing, a feeling of fullness in the ears); ototoxicity, vestibular
(clumsiness, dizziness, nausea, vomiting, unsteadiness); peripheral neuritis (burning of
face or mouth, numbness, tingling) - streptomycin only. Incidence less frequent:
Hypersensitivity (skin itching, redness, rash, or swelling); optic neuritis (any loss of
vision) - streptomycin only. Incidence rare: Neuromuscular blockade (difficulty in
breathing, drowsiness, weakness). /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 64]**PEER REVIEWED**
CNS depression, characterized by stupor, flaccidity, coma, or deep respiratory
depression, has been reported in very young infants receiving streptomycin at doses that
exceeded the maximum recommended amount. However, all aminoglycosides have this
potential to cause neuromuscular blockade. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
In general, the aminoglycosides have little allergenic potential; both anaphylaxis and rash
are unusual. Rare hypersensitivity reactions, including skin rashes, eosinophilia, fever,
blood dyscrasias, angioedema, exfoliative dermatitis, stomatitis, and anaphylactic shock,
have been reported. /Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1108]**PEER REVIEWED**
Because of their toxicity, aminoglycosides should be used with caution in elderly
patients, only after less toxic alternatives have been considered and/or found ineffective.
Elderly patients are more likely to have an age-related decrease in renal function.
Recommended doses should not be exceeded, and the patients's renal function should be
carefully monitored during therapy. Geriatric patients may require smaller daily doses of
aminoglycosides in accordance with their increased age, decreased renal function, and
possibly, decreased weight. In addition, loss of hearing may result even in patients with
normal renal function. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Since the incidence of nephrotoxicity and ototoxicity is related to the concentration to
which an aminoglycoside accumulates, it is critical to reduce the maintenance dosage of
these drugs in patients with impaired renal function. /Aminoglycosides/
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1103]**PEER REVIEWED**
The administration of streptomycin in particular may produce dysfunction of the optic
nerve. Scotomas, presenting as enlargement of the blind spot, have been associated with
the drug.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1107]**PEER REVIEWED**
The topical application of streptomycin is contraindicated because of the high risk of
sensitization and rapidly developing bacterial resistance.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 1497]**PEER REVIEWED**
Teratogenicity has been documented in laboratory animals. This drug should not be
administered during the first trimester of pregnancy or in total doses exceeding 20 g
during the last half of pregnancy to minimize the possibility of congenital deafness.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 1647]**PEER REVIEWED**
Interactions:
NON-IONIC, ANIONIC, & ZWITTERIONIC SURFACTANTS INDUCED A
RAPIDLY REVERSIBLE HYPER-ABSORPTIVE STATE IN THOMAS CANINE
FUNDIC POUCH FOR...STREPTOMYCIN... IN THE PRESENCE OF
SURFACTANTS, BLOOD LEVELS OF /STREPTOMYCIN/...WERE MANY TIMES
GREATER THAN VALUES IN CONTROLS.
[The Chemical Society. Foreign Compound Metabolism in Mammals. Volume 2: A
Review of the Literature Published Between 1970 and 1971. London: The Chemical
Society, 1972. 417]**PEER REVIEWED**
STREPTOMYCIN SHOULD NOT BE GIVEN CONCURRENTLY WITH POTENT
DIURETICS SUCH AS ETHACRYNIC ACID...OR FUROSEMIDE...WHICH CAN
PRODUCE OTOTOXICITY & MAY ADD TO OR POTENTIATE THE
OTOTOXICITY OF STREPTOMYCIN. ... USE OF ANESTHETICS &
NEUROMUSCULAR BLOCKING AGENTS WITH STREPTOMYCIN CAN
POTENTIATE NEUROMUSCULAR BLOCKADE & CAUSE RESPIRATORY
PARALYSIS...
[American Hospital Formulary Service. Volumes I and II. Washington, DC: American
Society of Hospital Pharmacists, to 1984.,p. 8:12.28]**PEER REVIEWED**
The effect of calcium 4'-phosphopantothenate (CPP) on acute toxicity of streptomycin
and the decr by the antibiotic of the muscle working capacity, "holes" reflex, body temp
and oxygen intake were studied on 258 albino mice weighing 22-26 g. Medical calcium
pantothenate (CPA) was used for control purposes. CPP is an antagonist of streptomycin
sulfate. In a dose of 1/10 or 1/5 of the LD50 injected ip CPP lowered acute toxicity of
streptomycin and prevented its effect in a dose of 0.11-1.1 g/kg injected sc on the
muscle working capacity, "holes" reflex and body temp. CPA lowered the streptomycin
effect on the "holes" reflex and body temp, while CPP prevented it.
[Dorofeev BF et al; Alteration of the acute toxicity and various pharmacologic effects of
streptomycin sulfate by calcium 4'-phosphopantothenate; Antibiotiki 28 (10): 760-3
(1983)]**PEER REVIEWED**
Concurrent and/or sequential use of 2 or more aminoglycosides by any route or
concurrent use of capreomycin with aminoglycosides should be avoided since the
potential for ototoxicity, nephrotoxicity, and neuromuscular blockage may be increased;
hearing loss may occur and may progress to deafness even after discontinuation of the
drug; loss of hearing may be reversible, but usually is permanent; neuromuscular
blockade may result in skeletal muscle weakness and respiratory depression or paralysis
(apnea). Also, concurrent use of 2 or more aminoglycosides may result in reduced
bacterial uptake of each one since the medications compete for the same uptake
mechanism. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Aminoglycosides can be inactivated by many beta-lactam antibiotics (cephalosporins,
penicillins) in vitro and in vivo in patients with significant renal failure. Degradation
depends on the concentration of the beta-lactam, storage time, and temperature.
/Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
When aminoglycosides are administered concurrently with intravenous indomethacin in
the premature neonate, renal clearance of aminoglycosides may be decreased, leading to
increased plasma concentrations, elimination half-lives, and risk of aminoglycoside
toxicity; dosage adjustment of aminoglycosides based on measurement of plasma
concentrations and/or evidence of toxicity may also be required. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Concurrent and/or sequential use of /methoxyflurane or parenteral polymyxins/ with
aminoglycosides should be avoided since the potential for nephrotoxicity and/or
neuromuscular blockade may be increased; neuromuscular blockade may result in
skeletal muscle weakness and respiratory depression or paralysis (apnea); caution is also
recommended when methoxyflurane or polymyxins are used concurrently with
aminoglycosides during surgery or in the postoperative period. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Concurrent use of medications with neuromuscular blocking activity, including
halogenated hydrocarbon inhalation anesthetics, opioid analgesics, and massive
transfusions with citrate anticoagulated blood, with aminoglycosides should be carefully
,monitored since neuromuscular blockade may be enhanced, resulting in skeletal muscle
weakness and respiratory depression or paralysis (apnea); caution is recommended when
these medications and aminoglycosides are used concurrently during surgery or in the
postoperative period, especially if there is a possibility of incomplete reversal of
neuromuscular blockade postoperatively; treatment with anticholinesterase agents or
calcium slats may help reverse the blockade. /Aminoglycosides/
[USP Convention. USPDI-Drug Information for the Health Care Professional. 14th ed.
Volume I. Rockville, MD: United States Pharmacopeial Convention, Inc., 1994. (Plus
Updates). 63]**PEER REVIEWED**
Many antibiotics (eg, streptomycin ...) enhance the neuromuscular block produced by
tubocurarine and other nondepolarizing agents.
[American Medical Association, Council on Drugs. AMA Drug Evaluations Annual
1994. Chicago, IL: American Medical Association, 1994. 206]**PEER REVIEWED**
Streptomycin reportedly causes false-positive results in urine glucose determinations
using cupric sulfate solution (Benedict's reagnet, Clintest).
[McEvoy, G.K. (ed.). American Hospital Formulary Service--Drug Information 94.
Bethesda, MD: American Society of Hospital Pharmacists, Inc. 1994 (Plus Supplements).
58]**PEER REVIEWED**
Drug Tolerance:
Bacteria may be resistant to the antimicrobial activity of the aminoglycosides because of
failure of permeation of the antibiotic /or/ low affinity of the drug for the bacterial
ribosome... The significance of the so-called permeability barrier as an explanation for
resistance to aminoglycosides among aerobic gram-negative bacilli is not known. This
mechanism is responsible for low-level resistance to streptomycin in many strains of
Pseudomonas aeruginosa. ... The second mechanism of resistance...is less relevant
clinically. ...from 18 to 40% of strains of enterococci isolated from pt with endocarditis
are resistant to high concn of streptomycin, and ribosomes from these strains fail to bind
streptomycin.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1101]**PEER REVIEWED**
Large populations of all strains of tubercle bacilli incl a number of cells that are markedly
resistant to the antibiotic because of mutation. However, primary resistance to
streptomycin is found in only 1 to 2% of isolates of M tuberculosis ... When
streptomycin was used alone, as many as 80% of pt harbored insensitive tubercle bacilli
after 4 mo of treatment; many of these microorganisms were not inhibited by concn of
drug as high as 1000 ug/ml.
[Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990.
1153]**PEER REVIEWED**
Environmental Fate & Exposure:
Natural Pollution Sources:
ANTIBIOTIC SUBSTANCE PRODUCED BY THE SOIL ACTINOMYCETE
STREPTOMYCES GRISEUS (KRAINSKY) WAKSMAN ET HENRICI (FAM
ACTINOMYCETACEAE).
[The Merck Index. 10th ed. Rahway, New Jersey: Merck Co., Inc., 1983. 1263]**PEER
REVIEWED**
Environmental Standards & Regulations:
FDA Requirements:
A tolerance of zero is established for residues of streptomycin in the uncooked edible
tissues of chickens, turkeys, and swine, and in eggs.
[21 CFR 556.610 (7/1/93)]**PEER REVIEWED**
Manufacturers, packers, and distributors of drug and drug products for human use are
responsible for complying with the labeling, certification, and usage requirements as
prescribed by the Federal Food, Drug, and Cosmetic Act, as amended (secs 201-902, 52
Stat. 1040 et seq., as amended; 21 U.S.C. 321-392).
[21 CFR 200-299, 300-499, 820, and 860 (4/1/93)]**PEER REVIEWED**
Allowable Tolerances:
A tolerance of zero is established for residues of streptomycin in the uncooked edible
tissues of chickens, turkeys, and swine, and in eggs.
[21 CFR 556.610 (7/1/93)]**PEER REVIEWED**
Chemical/Physical Properties:
Molecular Formula:
C21-H39-N7-O12
**PEER REVIEWED**
Molecular Weight:
581.58
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
Odor:
ODORLESS OR NEARLY SO
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
Taste:
SLIGHTLY BITTER TASTE
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
Solubilities:
SOL IN WATER
[Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th
ed. New York: Macmillan Publishing Co., Inc., 1975. 1167]**PEER REVIEWED**
Spectral Properties:
MAX ABSORPTION (0.2 M H3BO3): 280 NM (A= 2, 1%, 1 CM); (PH 9.4 BORATE
BUFFER): 318 NM (A= 2, 1%, 1 CM)
[Sunshine, I. (ed.). CRC Handbook of Analytical Toxicology. Cleveland: The Chemical
Rubber Co., 1969. 282]**PEER REVIEWED**
Other Chemical/Physical Properties:
HIGHLY POLAR ORGANIC BASE
[Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th
ed. New York: Macmillan Publishing Co., Inc., 1975. 1167]**PEER REVIEWED**
WHITE OR PRACTICALLY WHITE POWDER; HYGROSCOPIC; PH (1 IN 5 SOLN)
BETWEEN 4.5 AND 7.0 /STREPTOMYCIN SULFATE/
[Osol, A. (ed.). Remington's Pharmaceutical Sciences. 16th ed. Easton, Pennsylvania:
Mack Publishing Co., 1980. 1127]**PEER REVIEWED**
CLEAR, COLORLESS TO YELLOW, VISCOUS LIQUID /STREPTOMYCIN
SULFATE INJECTION/
[American Hospital Formulary Service. Volumes I and II. Washington, DC: American
Society of Hospital Pharmacists, to 1984.,p. 8:12.28]**PEER REVIEWED**
WHITE TO LIGHT GRAY OR PALE BUFF POWDER; FAINT AMINE-LIKE ODOR;
SOLUBILITY IN MG/ML AT ABOUT 28 DEG C: WATER GREATER THAN 20;
METHANOL 0.85; ETHANOL 0.30; ISOPROPANOL 0.01; PETROLEUM ETHER
0.015; CARBON TETRACHLORIDE 0.035; ETHER 0.035 /STREPTOMYCIN
SESQUISULFATE/
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
ALMOST INSOL IN ALCOHOL, CHLOROFORM, ETHER; HYGROSCOPIC AND
DELIQUESCENT ON EXPOSURE TO AIR /STREPTOMYCIN SALTS/
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
SPECIFIC OPTICAL ROTATION: -84 DEG @ 25 DEG C/D; SOLUBILITY IN
MG/ML AT ABOUT 28 DEG C: WATER GREATER THAN 20; METHANOL
GREATER THAN 20; ETHANOL 0.90; ISOPROPANOL 0.12; ISOAMYL ALC 0.117;
PETROLEUM ETHER 0.02; CARBON TETRACHLORIDE 0.042; ETHER 0.01
/STREPTOMYCIN TRIHYDROCHLORIDE/
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
Streptomycin solutions are not precipitated by alkali hydroxides or carbonates (except
that calcium carbonate may be precipitated in solutions of the double salt with calcium
chloride) or by alkaloid precipitants such as iodine TS, mercuric-potassium iodide TS, or
trinitrophenol TS.
[Chase et al; Remington's Pharmaceutical Sciences 14th ed. Mack Publ Co. Easton, PA p.
1233 (1970)]**PEER REVIEWED**
Chemical Safety & Handling:
Hazardous Decomposition:
... Streptomycin deteriorates if heated and should not be autoclaved.
[McEvoy, G.K. (ed.). American Hospital Formulary Service--Drug Information 94.
Bethesda, MD: American Society of Hospital Pharmacists, Inc. 1994 (Plus Supplements).
54]**PEER REVIEWED**
When heated to decomposition ... emits toxic fumes of /nitrogen oxides/.
[Lewis, R.J. Sax's Dangerous Properties of Industrial Materials. 9th ed. Volumes 1-3.
New York, NY: Van Nostrand Reinhold, 1996. 3019]**QC REVIEWED**
Stability/Shelf Life:
NOT AFFECTED BY AIR OR LIGHT /STREPTOMYCIN SALTS/
[The Merck Index. 10th ed. Rahway, New Jersey: Merck Co., Inc., 1983. 1263]**PEER
REVIEWED**
STABLE @ PH 3.7
[Martin, H. and C.R. Worthing (eds.). Pesticide Manual. 4th ed. Worcestershire, England:
British Crop Protection Council, 1974. 459]**PEER REVIEWED**
IRREVERSIBLY HYDROLYZED UNDER EITHER ACIDIC OR ALKALINE
CONDITIONS
[White-Stevens, R. (ed.). Pesticides in the Environment: Volume 1, Part 1, Part 2. New
York: Marcel Dekker, Inc., 1971. 30]**PEER REVIEWED**
The manufacturer states that streptomycin sulfate injection should be stored at 2-8
degrees C.
[McEvoy, G.K. (ed.). American Hospital Formulary Service--Drug Information 94.
Bethesda, MD: American Society of Hospital Pharmacists, Inc. 1994 (Plus Supplements).
67]**PEER REVIEWED**
Disposal Methods:
SRP: At the time of review, criteria for land treatment or burial (sanitary landfill)
disposal practices are subject to significant revision. Prior to implementing land disposal
of waste residue (including waste sludge), consult with environmental regulatory
agencies for guidance on acceptable disposal practices.
**PEER REVIEWED**
Streptomycin is unstable to heat and does not accumulate in the soil. Therefore, disposal
by incineration or burial should not result in harm to the environment. Recommendable
methods: Incineration & landfill. Not recommendable method: Discharge to sewer. Peer
review: Do not landfill in a recognizable form. (Peer-review conclusions of an IRPTC
expert consultation (May 1985))
[United Nations. Treatment and Disposal Methods for Waste Chemicals (IRPTC File).
Data Profile Series No. 5. Geneva, Switzerland: United Nations Environmental
Programme, Dec. 1985. 281]**PEER REVIEWED**
Occupational Exposure Standards:
Manufacturing/Use Information:
Major Uses:
FUNGICIDE
[White-Stevens, R. (ed.). Pesticides in the Environment: Volume 1, Part 1, Part 2. New
York: Marcel Dekker, Inc., 1971. 30]**PEER REVIEWED**
PLANT BACTERICIDE
[Martin, H. and C.R. Worthing (eds.). Pesticide Manual. 4th ed. Worcestershire, England:
British Crop Protection Council, 1974. 459]**PEER REVIEWED**
MEDICATION (VET)
**PEER REVIEWED**
MEDICATION
**PEER REVIEWED**
This antibiotic has been found to provide control of a number of commercially important
bacterial plant pathogens including fireblight of pear and apple, walnut blight, tomato
canker, bacterial canker, angular leaf blight of cotton, crown gall, olive knot, bacterial rot
of begonia, and bacterial spot of stone fruit, bacterial leaf spot of mung andguar
[FARM CHEM HDBK 1986 p.C-218]**PEER REVIEWED**
Manufacturers:
Pfizer Pharmaceuticals Inc, PO Box 628, Barceloneta, PR 00617, (809)946-4654
/medical and non-medical grade/
[USITC. SYN ORG CHEM-U.S. PROD/SALES 1984 p.100]**PEER REVIEWED**
Eli Lilly & Co, 307 E. McCarthy St, Indianapolis, IN 46285, (317)261-2000 /nonmedical grade/
[USITC. SYN ORG CHEM-U.S. PROD/SALES 1984 p.101]**PEER REVIEWED**
Pfizer Inc., Chemical Division., 235 East 42nd Street, New York, NY 10017 (212)5732323. Production Sites: Groton, CT 06340; Terre Haute, Indiana 47808. /non-medicinal
streptomycin/
[SRI. 1994 Directory of Chemical Producers -United States of America. Menlo Park, CA:
SRI International, 1994.. 745]**PEER REVIEWED**
Methods of Manufacturing:
PRODN BY AEROBIC FERMENTATION & PURIFICATION: TISHLER IN
STREPTOMYCIN, SELMAN A WAKSMAN, ED (WILLIAMS & WILKINS,
BALTIMORE, 1949) PAGES 32-54. ISOLATION & PURIFICATION BY ION
EXCHANGE: BARTELS ET AL, CHEM ENG PROGR 54 (8), 49-51 (AUG 1958);
BARTELS ET AL, US PATENT 2,868,779 (1959 TO OLIN MATHIESON). ... TOTAL
SYNTHESIS: UMEZAWA ET AL, J ANTIBIOT 27, 997 (1974).
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
Produced via aerobic fermentation of the soil Actinomycete, Streptomyces griseus.
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
General Manufacturing Information:
DRUG IS MADE UP OF THREE COMPONENTS--STREPTIDINE, STREPTOSE, &
N-METHYL-L-GLUCOSAMINE...
[Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th
ed. New York: Macmillan Publishing Co., Inc., 1975. 1167]**PEER REVIEWED**
...IS A BACTERICIDE EFFECTIVE FOR THE PROTECTION OF PLANTS FROM
BACTERIAL DISEASES SUCH AS...WILD FIRE OF TOBACCO...
[Martin, H. and C.R. Worthing (eds.). Pesticide Manual. 4th ed. Worcestershire, England:
British Crop Protection Council, 1974. 459]**PEER REVIEWED**
...CONTROL OF...BACTERIAL PLANT PATHOGENS INCLUDING FIREBLIGHT
OF PEAR & APPLE, WALNUT BLIGHT, TOMATO CANKER, BACTERIAL
CANKER, ANGULAR LEAF BLIGHT OF COTTON, CROWN GALL, OLIVE KNOT,
BACTERIAL ROT OF BEGONIA, & BACTERIAL SPOT OF STONE FRUIT,
BACTERIAL LEAF SPOT OF MUNG AND GUAR.
[Farm Chemicals Handbook 1984. Willoughby, Ohio: Meister Publishing Co., 1984.,p.
C-212]**PEER REVIEWED**
FUNGICIDE TOLERANCE: 0.25 PPM; CROPS & USE RESTRICTIONS: CELERY,
PEPPER, TOMATO--PLANT BEDS ONLY (200 PPM SPRAY); POTATO-SEEDPIECE TREATMENT ONLY (100 PPM DIP OR DUST). SOAK CUT PIECES
LESS THAN 30 MIN. BEANS--SEED TREATMENT FOR HALO BLIGHT
CONTROL. DO NOT USE TREATED SEED FOR FOOD OR FEED.
[White-Stevens, R. (ed.). Pesticides in the Environment: Volume 2. New York: Marcel
Dekker, Inc., 1976. 173]**PEER REVIEWED**
THE FIRE-BLIGHT BACTERIUM, ERWINIA AMYLOVORA & THE PEPPER
BACTERIUM, XANTHOMONAS VESICATORIA, ARE NOW RESISTING
CONTROL BY STREPTOMYCIN SPRAYS IN DELAWARE.
[White-Stevens, R. (ed.). Pesticides in the Environment: Volume 1, Part 1, Part 2. New
York: Marcel Dekker, Inc., 1971. 458]**PEER REVIEWED**
This agent should not be applied following Bordeaux mixt and it is incompatible with
lime sulfur, pyrethrane, and aldrin.
[Osol, A. (ed.). Remington's Pharmaceutical Sciences. 16th ed. Easton, Pennsylvania:
Mack Publishing Co., 1980. 1208]**PEER REVIEWED**
Formulations/Preparations:
STREPTOMYCIN SULFATE, USP, IS SUPPLIED FOR PARENTERAL INJECTION
EITHER AS A STERILE DRY POWDER OR IN STERILE SOLN. EACH VIAL
CONTAINS THE EQUIV OF 1 OR 5 G OF THE BASE; SOLN, WHICH ARE
STABLE FOR MONTHS, CONTAIN 500 MG/ML. /STREPTOMYCIN SULFATE/
[Gilman, A. G., L. S. Goodman, and A. Gilman. (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 6th ed. New York: Macmillan Publishing Co.,
Inc. 1980. 1171]**PEER REVIEWED**
Streptomycin is usually avail as the trihydrochloride, trihydrochloride-calcium chloride
double salt, phosphate, or sesquisulfate, which occurs as granules or powder.
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
Agrimycin 100: 15% streptomycin, 1.5% Terramycin (Oxytetracycline)... Dusts, 0.10.2%; Wettable powder 8.5-62.5%. May be combined with copper.
[Spencer, E. Y. Guide to the Chemicals Used in Crop Protection. 7th ed. Publication
1093. Research Institute, Agriculture Canada, Ottawa, Canada: Information Canada,
1982. 525]**PEER REVIEWED**
This antibiotic is marketed as the sulfate or nitrate under the trade names Agrimycin 17,
AG-Strep, and Phytomycin by Pfizer, Merck, and Olin Mathieson.
[Osol, A. (ed.). Remington's Pharmaceutical Sciences. 16th ed. Easton, Pennsylvania:
Mack Publishing Co., 1980. 1208]**PEER REVIEWED**
Units: one unit equals one microgram of pure crystalline streptomycin base.
[Lewis, R.J., Sr (Ed.). Hawley's Condensed Chemical Dictionary. 12th ed. New York,
NY: Van Nostrand Rheinhold Co., 1993 1093]**PEER REVIEWED**
Combinations: Streptomycin-oxytetracycline mixture; streptomycin-tetracycline
hydrochloride mixture
[FARM CHEM HDBK 1986 p.C-218]**PEER REVIEWED**
Agri-Mycin 17, Agri-Strep, Plantomycin
[FARM CHEM HDBK 1986 p.C-218]**PEER REVIEWED**
U. S. Production:
(1986) ND
**PEER REVIEWED**
U. S. Imports:
(1986) ND
**PEER REVIEWED**
U. S. Exports:
(1986) ND
**PEER REVIEWED**
Laboratory Methods:
Clinical Laboratory Methods:
PAPER DISC MICROMETHODS WERE DEVELOPED FOR DETERMINATION OF
CONCN OF STREPTOMYCIN IN WHOLE BLOOD. BACILLUS SUBTILIS WAS
USED FOR STREPTOMYCIN. METHODS ARE SUITABLE FOR USE IN
NEONATES.
[KLAIN S; MICROMETHODS FOR DETERMINATION OF THE
CONCENTRATION OF ANTIBIOTICS IN WHOLE BLOOD AND SERUM; PROBL
PEDIATR 17: 43-9 (1974)]**PEER REVIEWED**
URINE SAMPLES WERE TREATED WITH SODIUM HYDROXIDE, HEATED, &
THEN TREATED WITH SOLN OF POTASSIUM FERROCYANIDE & SODIUM
NITROPRUSSIDE. A BLUE FILTER WAS USED FOR COLORIMETRIC
MEASUREMENTS.
[SMIRNOV GA; SIMPLIFIED MODIFICATION OF METHODS FOR
DETERMINING STREPTOMYCIN AND DIHYDROSTREPTOMYCIN IN URINE;
LAB DELO 11: 680-1 (1974)]**PEER REVIEWED**
MICROMETHOD FOR DETERMINATION OF ANTIBIOTIC CONCN IN BODY
FLUIDS IS PRESENTED.
[ERICSSON H, MALMBORG AS; MICROMETHOD FOR DETERMINATION OF
ANTIBIOTIC CONCENTRATIONS IN BODY FLUIDS; ACTA PATHOL
MICROBIOL SCAND SUPPL (241) 107-10 (1973)]**PEER REVIEWED**
Analytic Laboratory Methods:
SAMPLES WERE ASSAYED MICROBIOLOGICALLY TO DETERMINE
STREPTOMYCIN RESIDUES ON SKIN & IN FLESH OF PEACH, PLUM,
APRICOT, APPLE, & PEAR FRUIT.
[DYE MH, MOSSOP DW; STREPTOMYCIN RESIDUES AND NATURAL
ANTIBACTERIAL COMPOUNDS IN FRUIT; NZ J AGRIC RES 17 (2): 157-64
(1974)]**PEER REVIEWED**
BASED ON REACTION WITH FLUORESCAMINE, NMOLE AMT OF 5 BASIC
ANTIBIOTICS WERE DETERMINED BY FLUOROMETRY. THE LIMIT OF
DETECTION FOR STREPTOMYCIN: 480 NG/ML.
[KUSNIR J, BARNA K; FLUORIMETRIC DETERMINATION OF SOME BASIC
ANTIBIOTICS AT VERY LOW CONCENTRATIONS; FRESENIUS' Z ANAL CHEM
271 (4): 288 (1974)]**PEER REVIEWED**
AOAC Method 988.09. Antimicrobial Drugs in Milk. Microbial Receptor Assay.
Detection limit for streptomycin is 10 ng/ml. Assay is based on binding reaction
between drug functional group and receptor site on added microbial cells. 14C or 3H
binding is measured by scintillation counter and compared with zero standard milk to
detect antimicrobials. The greater the amount of antibiotic present in the sample, the
lower the counts. Method does not detect metabolites, only active drugs.
[Association of Official Analytical Chemists. Official Methods of Analysis. 15th ed. and
Supplements. Washington, DC: Association of Analytical Chemists, 1990 829]**PEER
REVIEWED**
AOAC Method 972.57. Streptomycin in Feeds- Microbiological Method. Applicable to
feeds containing streptomycin at 5-30 g/ton.
[Association of Official Analytical Chemists. Official Methods of Analysis. 15th ed. and
Supplements. Washington, DC: Association of Analytical Chemists, 1990 128]**PEER
REVIEWED**
Special References:
Special Reports:
HUBER WG; STREPTOMYCIN, CHLORAMPHENICOL, AND OTHER
ANTIBACTERIAL AGENTS; VET PHARMACOL THER 4TH ED 940-71 (1977).
VET: A REVIEW OF STREPTOMYCIN, CHLORAMPHENICOL, & OTHER
ANTIBACTERIAL COMPD WITH MANY REFERENCES.
Toxicology Review: Internist 15 (1): 7 (1974)
Toxicology Review: Clinical Pharmacol & Therapeutics 5: 480 (1964)
Toxicology Review: Annual Review of Pharmacology 5: 447 (1965)
Toxicology Review: Advances in Pharmacology 4: 263 (1966)
Toxicology Review: Journal of Pediatrics 59: 1 (1961)
Toxicology Review: British Medical Journal 2: 260 (1965)
WHO; Environmental Health Criteria 119: Principles and Methods for the Assessment of
Nephrotoxicity Associated with Exposure to Chemicals (1991)
Gal P, Sharpless MK; Fetal drug exposure-behavioral teratogenesis; Drug Intell Clin
Pharm 18 (3): 186-201 (1984). This paper reviews the neurobehavioral and
developmental effects of fetal exposure to drugs, incl streptomycin.
Synonyms and Identifiers:
Synonyms:
Agrept
**PEER REVIEWED**
AGRIMYCIN
**PEER REVIEWED**
AGRIMYCIN 17
**PEER REVIEWED**
CHEMFORM
**PEER REVIEWED**
2,4-DIGUANIDINO-3,5,6-TRIHYDROXYCYCLOHEXYL 5-DEOXY-2-O-(2DEOXY-2-METHYLAMINO-ALPHA-L-GLUCOPYRANOSYL)-3-C-FORMYLBETA-L- LYXOPENTANOFURANOSIDE
**PEER REVIEWED**
GEROX
**PEER REVIEWED**
HOKKO-MYCIN
**PEER REVIEWED**
NEODIESTREPTOPAB
**PEER REVIEWED**
NSC-14083
**PEER REVIEWED**
STREPCEN
**PEER REVIEWED**
D-STREPTAMINE, O-2-DEOXY-2-(METHYLAMINO)-ALPHA-LGLUCOPYRANOSYL-(1-2)-O-5-DEOXY-3-C-FORMYL- ALPHA-LLYXOFURANOSYL-(1-4)-N,N'-BIS(AMINOIMINOMETHYL)**PEER REVIEWED**
Streptomicina [Italian]
**PEER REVIEWED**
STREPTOMYCIN A
**PEER REVIEWED**
STREPTOMYCINE
**PEER REVIEWED**
Streptomycinum
**PEER REVIEWED**
STREPTOMYZIN [GERMAN]
**PEER REVIEWED**
Associated Chemicals:
Streptomycin sulfate;16103-16-5
Streptomycin sulfate;3810-74-0
Streptomycin hydrochloride;41325-73-9
Streptomycin hydrochloride;6160-32-3
Streptomycin hydrochloride;70614-15-2
Formulations/Preparations:
STREPTOMYCIN SULFATE, USP, IS SUPPLIED FOR PARENTERAL INJECTION
EITHER AS A STERILE DRY POWDER OR IN STERILE SOLN. EACH VIAL
CONTAINS THE EQUIV OF 1 OR 5 G OF THE BASE; SOLN, WHICH ARE
STABLE FOR MONTHS, CONTAIN 500 MG/ML. /STREPTOMYCIN SULFATE/
[Gilman, A. G., L. S. Goodman, and A. Gilman. (eds.). Goodman and Gilman's The
Pharmacological Basis of Therapeutics. 6th ed. New York: Macmillan Publishing Co.,
Inc. 1980. 1171]**PEER REVIEWED**
Streptomycin is usually avail as the trihydrochloride, trihydrochloride-calcium chloride
double salt, phosphate, or sesquisulfate, which occurs as granules or powder.
[Budavari, S. (ed.). The Merck Index - Encyclopedia of Chemicals, Drugs and
Biologicals. Rahway, NJ: Merck and Co., Inc., 1989. 1390]**PEER REVIEWED**
Agrimycin 100: 15% streptomycin, 1.5% Terramycin (Oxytetracycline)... Dusts, 0.10.2%; Wettable powder 8.5-62.5%. May be combined with copper.
[Spencer, E. Y. Guide to the Chemicals Used in Crop Protection. 7th ed. Publication
1093. Research Institute, Agriculture Canada, Ottawa, Canada: Information Canada,
1982. 525]**PEER REVIEWED**
This antibiotic is marketed as the sulfate or nitrate under the trade names Agrimycin 17,
AG-Strep, and Phytomycin by Pfizer, Merck, and Olin Mathieson.
[Osol, A. (ed.). Remington's Pharmaceutical Sciences. 16th ed. Easton, Pennsylvania:
Mack Publishing Co., 1980. 1208]**PEER REVIEWED**
Units: one unit equals one microgram of pure crystalline streptomycin base.
[Lewis, R.J., Sr (Ed.). Hawley's Condensed Chemical Dictionary. 12th ed. New York,
NY: Van Nostrand Rheinhold Co., 1993 1093]**PEER REVIEWED**
Combinations: Streptomycin-oxytetracycline mixture; streptomycin-tetracycline
hydrochloride mixture
[FARM CHEM HDBK 1986 p.C-218]**PEER REVIEWED**
Agri-Mycin 17, Agri-Strep, Plantomycin
[FARM CHEM HDBK 1986 p.C-218]**PEER REVIEWED**
Administrative Information:
Hazardous Substances Databank Number: 1768
Last Revision Date: 20020114
Last Review Date: Reviewed by SRP on 5/11/1995
Update History:
Complete Update on 01/14/2002, 1 field added/edited/deleted.
Complete Update on 08/09/2001, 1 field added/edited/deleted.
Complete Update on 03/28/2000, 1 field added/edited/deleted.
Complete Update on 02/08/2000, 1 field added/edited/deleted.
Complete Update on 02/02/2000, 1 field added/edited/deleted.
Complete Update on 11/18/1999, 1 field added/edited/deleted.
Complete Update on 09/21/1999, 1 field added/edited/deleted.
Complete Update on 06/03/1999, 1 field added/edited/deleted.
Complete Update on 03/19/1999, 1 field added/edited/deleted.
Complete Update on 06/02/1998, 1 field added/edited/deleted.
Complete Update on 10/23/1997, 1 field added/edited/deleted.
Complete Update on 06/30/1997, 3 fields added/edited/deleted.
Complete Update on 01/27/1997, 1 field added/edited/deleted.
Complete Update on 01/21/1996, 1 field added/edited/deleted.
Complete Update on 09/13/1995, 30 fields added/edited/deleted.
Field Update on 12/28/1994, 1 field added/edited/deleted.
Complete Update on 10/19/1994, 1 field added/edited/deleted.
Complete Update on 08/23/1994, 1 field added/edited/deleted.
Complete Update on 02/02/1994, 1 field added/edited/deleted.
Complete Update on 11/01/1993, 1 field added/edited/deleted.
Complete Update on 01/20/1993, 1 field added/edited/deleted.
Field update on 12/22/1992, 1 field added/edited/deleted.
Complete Update on 05/21/1990, 1 field added/edited/deleted.
Complete Update on 10/14/1986