II. Indications

  1. Active Tuberculosis Treatment
    1. Used together with multiple other agents, typically 4 drug regimens

III. Contraindications

  1. Pregnancy

IV. Mechanism

  1. See Aminoglycoside
  2. Streptomycin is an Aminoglycoside antibiotic derived from Streptomyces griseus

V. Dosing: Tuberculosis Combination Therapy

  1. See Active Tuberculosis Treatment
  2. Adults
    1. Give 15 mg/kg (maximum 1 gram) IV or IM daily
  3. Older adults (age >60 years)
    1. Give 10 mg/kg (maximum 750 mg) IV or IM daily
  4. Children
    1. Give 20 to 40 mg/kg (maximum 1 gram) IM daily (FDA approved) OR
    2. Give 15 mg/kg (maximum 1 gram) IM daily (off label)

VI. Adverse Effects

  1. See Aminoglycoside
  2. Aminoglycosides are associated with risk of Ototoxicity and nephrotoxicity (FDA black box warning)
    1. See Aminoglycoside for risk factors

VII. Safety

  1. Pregnancy Category D
  2. Considered safe in Lactation
  3. Monitoring (baseline and monthly)
    1. Audiogram
    2. Renal Function
    3. Vestibular Testing
    4. Rhomberg testing

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