Streptomycin is the first antibiotic that has proven effective against mycobacteria tuberculosis and plaque. It effectively fights most gram-negative microorganisms, therefore it is used for the treatment of tularemia and brucellosis, as well as in the complex therapy of intestinal infections and infectious diseases of the urinary system.
Features of the drug
Streptomycin( Latin Streptomycinum) is a preparation of the first generation of aminoglycoside antibiotics. Has a high toxicity for the body, therefore it is used only in cases of acute necessity and impossibility of treatment with other medications.
Dosage forms
Streptomycin is made in the form of sulfate( Latin Streptomycini sulfas) - a powdery mass of whitish color. It is produced in one dosage form - a sterile powder for dilution. Can be used:
- for parenteral administration( injections),
- for topical application in the form of an aerosol or spray,
- or in the form of inhalations for the treatment of lungs.
Composition of streptomycin
One bottle contains streptomycin sulfate in various dosages:
- 0.25 g( 250,000 units);
- 0.5 g( 500,000 units);
- 1 g( 1,000,000 units).
Prices
The cost of streptomycin sulfate is about 100-120 rubles per package of 10 hermetically sealed bottles. But to find streptomycin in a free sale in pharmacies can be difficult.
Pharmacological action
Pharmacodynamics
Antibacterial action occurs due to the inhibition of protein production in the body of bacteria. Streptomycin is most active against Gram-negative bacteria( gonococci, Escherichia coli, Brucella, Mycobacterium tuberculosis).
Corynebacteria( pathogens of diphtheria) and staphylococci are sensitive to streptomycin. Relatively low susceptibility of the drug in streptococci, including pneumococcus( causative agent of pneumonia) and enterobacter( conditionally pathogenic microorganisms, often causing damage to the genitourinary system).
For the following groups of pathogenic microorganisms, streptomycin is ineffective:
- Anaerobic bacteria.
- Pseudomonas aeruginosa.
- of Proteus.
- of Rickettsia.
- A number of strains of spirochaetes.
Pharmacokinetics
Streptomycin sulfate rapidly penetrates into the bloodstream from the site of administration or application. When ingestion( by ingestion) is extremely poorly absorbed in the stomach and intestines, it is excreted unchanged along with the feces. Therefore, it is practically not prescribed for oral administration, with the exception of intestinal infections.
Indications
The main indication for the use of streptomycin is primary pulmonary tuberculosis, as well as nephrotuberculosis, skin tuberculosis, and tuberculous meningitis. It is prescribed as part of a comprehensive antituberculous therapy.
Other readings:
- Venereal granuloma( formation of ulcers on the skin of the genitals).
- Plague( acute, highly contagious, complex damage to the body).
- Brucellosis( systemic damage to the body with a pronounced increase in lymph nodes, pathologies of the heart, lungs, liver, kidneys, musculoskeletal system).
- Tularemia( characterized by a sharp increase in lymph nodes, fever, the formation of abscesses, ulcers and abscesses all over the body).
- Syphilis( with allergy or ineffectiveness of penicillins).
- Infections of the urinary system( with an identified and confirmed pathogen).
- Intestinal infections.
- Tuberculosis( vulgar) lupus in children.
- Enteritis bacterial nature.
- Frostbite( if suspected to develop infection and suppuration).
- Endocarditis of infectious etiology( in combination with other antibiotics).
- Apical petrosite.
- Ringworm scrofulous.
In dermatology, streptomycin is widely used to treat tuberculous skin lesions. Can be administered either through injections( injections) or topically, by applying a mixture, solution or suspension to the affected areas.
In dermatovenerology, streptomycin is used to treat a venereal granuloma. The disease is characterized by the formation of deep ulcers on the skin of the genital organs, more rarely - on the neck, face or in the mouth. Even after successful treatment, a relapse after 6-10 months is possible, which will require a repeated course of antibacterial therapy.
Instructions for Use
Adults
The recommended daily dose is 2 g( 2000 mg or 2,000,000 units).For the elderly, the daily dose is significantly less - to 0.75 g( 750 mg or 750,000 units).
Treatment of pathologies caused by mycobacterium tuberculosis is carried out according to an individually selected scheme. The duration of antibiotic therapy depends on several parameters:
- on the form, severity and stage of the disease;
- from the patient's tolerance of the drug( are there any side effects);
- from the presence of positive dynamics.
To treat a venereal granuloma, intramuscular injections are administered 2 times a day. Single dose 250 mg( 250,000 units).
In tularemia, streptomycin is administered at 1000 mg per day. It is recommended to continue antibacterial therapy up to 5 days of normal body temperature.
Treatment of plague requires the administration of doses far exceeding those recommended:
- With an average severity of the skin or bubonic form, 500 or 375 mg should be administered so that the total daily dose is 1.5 g of streptomycin.
- In severe plague it is necessary to bring the total dose per day to 3 g - 1000 mg every 8 hours.
- In septic( with blood infection) and pulmonary form of plague, the daily dose of streptomycin is 4 g in the first 4 days of treatment, with the maximum single dose being 1 g. On day 5, the dosage is reduced to 3 g per day, 0.75 g per dayone injection.
In brucellosis, the daily dose of streptomycin increases to 2 g, 1 g every 12 hours. The danger is the early cancellation of the drug or a reduction in dosage, because the chronic form of brucellosis can develop.
For other diseases( endocarditis, intestinal infections and infectious pathologies of the urinary tract), the treatment regimen is very similar. It is prescribed for 120 mg or 250 mg twice a day. When the pathology and serious condition of the patient are started, the frequency of administration can increase up to 3 injections per day. The duration of the course is from 3 to 10 days.
For children and newborns
For children older than one year, the permissible daily dose is 0.5 g( 500 mg or 500,000 units), for adolescents over 14 years, 1 g( 1000 mg or 1,000,000 units).Dosage is calculated based on body weight - no more than 20 mg per 1 kg.
Calculation of dosage for children of the first year of life is as follows:
- from 1 to 3 months.- no more than 10 mg per 1 kg per day;
- from 4 to 6 months.- not more than 15 mg per 1 kg day;
- from 7 months.and older - no more than 20 mg per 1 kg per day.
Streptomycin is highly toxic and has many side effects, so it is extremely rare to treat children. For the treatment of newborns, the drug can be used only if it is not possible to provide treatment with other antibiotics that are effective against the identified pathogen.
In pregnancy and lactation
Pregnant and lactating women can be prescribed only with a direct life threat. Streptomycin penetrates into amniotic fluid and is secreted into breast milk.
Contraindications
- Severe heart or kidney failure.
- Hearing or vestibular apparatus.
- Myasthenia gravis( an autoimmune disease that provokes muscle stiffness disorder).
- Intolerance to streptomycin.
- Pathologies of cerebral circulation of any etiology.
- Endarteritis( a decrease in the lumen of the arteries of the extremities against the background of inflammation of the membrane).
Pregnancy and the period of breastfeeding are not absolute contraindications, however streptomycin treatment is rarely prescribed.
Side effects of
Digestive system:
- vomiting and nausea, feeling of heaviness;
- loose stool;
- bile production disorder;
- dysfunction of the liver.
Nervous system:
- drowsiness;
- feeling tired;
- neuritis, especially the facial nerves( feeling of soreness, tingling, numbness or burning sensation along the nerve);
- muscle twitching;
- paresis and paresthesia( numbness, chills).
Streptomycin has several specific side effects:
- Nephrotoxicity - is able to accumulate in the cortex, which can cause impaired renal function.
- Ototoxicity - streptomycin adversely affects the hearing aid, can cause temporary or irreversible deafness, severe hearing loss, "ringing in the ears".
- Vestibular apparatus disorders - dizziness, disorientation, loss of coordination are possible.
Other common side effects may occur, such as an allergic reaction, redness, and itching at the injection or application site.
Special instructions
Streptomycin is listed in the list of essential medicines, but is dispensed from pharmacies only on prescription. Treatment should be carried out under the constant supervision of physicians with weekly monitoring of kidney, hearing and vestibular apparatus.
Interaction with other drugs and alcohol
- Streptomycin is not prescribed when using other aminoglycosides( florimycin sulfate, kanamycin), since in combination the drugs decrease the effectiveness of each other.
- Also streptomycin is not prescribed for treatment with drugs toxic to the kidneys and liver.
- May be administered in combination therapy with antibiotics of the penicillin and cephalosporin series. In this case, the effectiveness of both drugs increases.
- Clindamycin increases the action of streptomycin.
- The simultaneous use of gentamicin and streptomycin is contraindicated.
- Together with Anauran and streptomycin, the ototoxic effect is enhanced.
Reviews
The use of streptomycin was of great importance for the treatment of diseases such as plague and tuberculosis. Before the discovery of this antibiotic, the diseases were considered incurable. Therefore, the appointment of even large doses of streptomycin is considered adequate for the treatment of pathologies that threaten the fatal outcome.
In pediatrics, the use of streptomycin is justified only by life indications, when the life of a child is at stake. The drug is extremely toxic to the child's body, can provoke the development of a number of irreversible changes in hearing and kidney structure.
Analogs
Analogues by group( aminoglycosides):
- Kanamycin( ~ 120 rubles);
- Neomycin( ~ 300 rubles);
- Gentamicin( ~ 80 rubles);
- Amikacin( ~ 330 rubles).
The harm of streptomycin and other antibiotics is described in this video: