Streptomycin - instructions for the use of antibiotics, reviews, analogs and release forms (injections in ampoules for injection of 0.5 g and 1 g) of a drug for the treatment of tuberculosis, plague, brucellosis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Streptomycin. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of antibiotics Streptomycin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of streptomycin in the presence of existing structural analogues.Use for the treatment of tuberculosis, plague, brucellosis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Streptomycin - an antibiotic of a group of aminoglycosides of a wide spectrum of action. Has a bactericidal effect due to binding to the 30S subunit of the bacterial ribosome, which further leads to inhibition of protein synthesis.

It is active against Mycobacterium tuberculosis, as well as most gram-negative bacteria: Escherichia coli (E. coli), Salmonella spp. (salmonella), Shigella spp. (shigella), Yersinia spp., Haemophilus influenzae, Klebsiella spp. (including Klebsiella pneumoniae) (Klebsiella), Neisseria gonorrhoeae, Neisseria meningitidis, Yersinia pestis, Francisella tularensis, Brucella spp.

Streptomycin is sensitive to Staphylococcus spp. (Staphylococcus aureus), Corynebacterium diphtheriae.

Less active against Streptococcus spp. (including Streptococcus pneumoniae) (streptococcus), Enterobacter spp.

Streptomycin is inactive against anaerobic bacteria: Spirochaetaceae, Rickettsia spp., Proteus spp. (Proteus), Pseudomonas aeruginosa.

Composition

Streptomycin sulfate + excipients.

Pharmacokinetics

After intramuscular injection, streptomycin is rapidly and completely absorbed from the injection site. It is distributed in all tissues of the body. Binding to plasma proteins is low (0-10%). It is not metabolized. It is excreted unchanged in the urine.

Indications

• tuberculosis of different localization, incl.tuberculous meningitis (as part of combination therapy);
• venereal granuloma;
• tularemia, brucellosis, plague;
• bacterial endocarditis (only in combination with benzylpenicillin or vancomycin);
• acute bacterial intestinal infections, urinary tract infections (after the sensitivity of the pathogen).

Forms of release

Powder for solution for intramuscular injection 0.5 g and 1 g (injections in ampoules for injection).

Other dosage forms, be it tablets, capsules or ointment, do not exist.

Instructions for use and dosing regimen

Intramuscularly.

Adults single dose with a / m introduction - 0.5-1 g, daily - 1-2 g. The maximum daily dose of streptomycin for an adult is 2 g. With poor tolerance to patients with a body weight of less than 50 kg, and also those over 60 years of age The daily dose is 750 mg.

Children under the age of 3 months - in a dose of 10 mg / kg per day, from 3 to 6 months - 15 mg / kg per day, from 6 months to 2 years - 20 mg / kg per day, for children under 13 years and adolescents - 15-20 mg / kg per day, but not more than 500 mg per day - for children under 13 years and 1 g per day - for adolescents.

Maximum doses of streptomycin to children of different ages: 2-4 years, single dose 150 mg, daily 300 mg; 5-6 years single dose - 175 mg, daily - 350 mg; 7-9 years single dose - 200 mg, daily - 400 mg; 9 - 14 years single dose - 250 mg, daily - 500 mg; over 14 years of age, single dose of 500 mg, daily - 1 g.

Tuberculosis of the lungs and other organs - a daily dose (15 mg / kg, but not more than 1 g) is administered 1 time per day, with poor tolerance - in 2 divided doses; duration of treatment 3 months or more (in parallel with the administration of other antituberculous drugs).

Bacterial endocarditis:

• streptococcal etiology (caused by Streptococcus spp., sensitive to penicillin) - streptomycin is given in combination with benzylpenicillin for 2 weeks; in 1-st week - 1 g 2 times a day; during the 2nd week - 500 mg 2 times a day; patients older than 60 years - 500 mg twice a day for 2 weeks;
• enterococcal etiology - streptomycin is administered in combination with benzylpenicillin for 6 weeks; in the first 2 weeks - 1 g 2 times a day; for the next 4 weeks - 500 mg twice a day (the duration of treatment can be reduced with ototoxicity phenomena).

Tularemia - 0.5-1 g 2 times a day for 7-14 days until the 5th-7th day of absence of febrile temperature.

Plague, brucellosis - 1 g 2 times a day for at least 7-10 days.

With a venereal granuloma, acute bacterial intestinal infections and urinary tract infections - the daily dose is divided into 2-4 injections, the duration of the course - at least 10 days (should not exceed 14 days).

With renal failure, the daily dose of streptomycin should be reduced. With Cl creatinine from 50 to 60 ml / min, the dose should not exceed 500 mg per day; from 40 to 50 ml / min - not more than 400 mg per day.

For patients with arterial hypertension and ischemic heart disease, the initial dose is 250 mg per day, with good tolerability, the dose is increased.

Preparation of the solution

The contents of the vial are dissolved in sterile water for injection or 0.9% solution of sodium chloride, or in a 0.25-0.5% solution of procaine (Novocaine), based on 4 ml of solvent per gram of streptomycin. The solution is prepared immediately prior to administration.

Side effect

• nephrotoxic action (albuminuria, hematuria);
• toxic effect on the 8th pair of cranial nerves (hearing loss, up to the development of deafness, ringing, feeling of stuffing in the ears, dizziness, nausea, vomiting, instability);
• peripheral neuritis;
• optic neuritis;
• neuromuscular blockade (difficulty breathing, apnea, weakness, drowsiness);
• diarrhea;
• hives;
• itching;
• skin rash.

Contraindications

• obliterating endarteritis;
• myasthenia gravis;
• diseases associated with inflammation of 8 pairs of cranial nerves;
• severe forms of cardiovascular and renal failure;
• disorders of cerebral circulation;
• increased sensitivity to streptomycin;
• pregnancy;
• lactation (breastfeeding).

Application in pregnancy and lactation

Contraindicated in the use of streptomycin during pregnancy and lactation.

Streptomycin penetrates the placental barrier and can have a nephrotoxic effect on the human fetus. Infants whose mothers received streptomycin during pregnancy may develop deafness. Excreted in breast milk.

Use in children

Children under 1 year of age Streptomycin is prescribed only for life indications.

special instructions

During the treatment with streptomycin, it is necessary to monitor the functions of the vestibular and hearing aids, the functions of the kidneys.

When unsatisfactory audiometric tests, the dose of the drug is reduced or discontinued.

Patients with impaired renal excretory function, as well as patients with liver damage should be reduced daily dose.

In the absence of positive clinical dynamics should be remembered the possibility of developing resistant microorganisms.In such cases, it is necessary to cancel treatment and begin appropriate therapy.

Intracavernous injection of Streptomycin is not recommended when the pleural cavity is not inflated at the site of catheter insertion and in the case of the basal localization of caverns.

Practiced using in veterinary practice for the treatment of plague (plague) in domestic animals - cats and dogs.

Influence on ability to drive vehicles and work with mechanisms

During the administration of the drug, care should be taken when driving vehicles, mechanisms and other potentially hazardous activities that require a high concentration of attention and speed of psychomotor reactions.

Drug Interactions

When used simultaneously with aminoglycosides, polymyxins, capreomycin, the risk of oto- and nephrotoxic action increases.

With the simultaneous use of streptomycin with drugs blocking neuromuscular transmission (including funds for inhalation anesthesia, opioid analgesics), neuromuscular blockade may increase.

Streptomycin exhibits synergism with simultaneous use with beta-lactam antibiotics (penicillins and cephalosporins).

Reduces the effectiveness of antimiasthenic drugs.

Methoxyflurane increases the risk of developing side effects of streptomycin.

Analogues of the drug Streptomycin

Structural analogs for the active substance:

• Streptomycin sulfate.

Analogues on the curative effect (funds for the treatment of tuberculosis):

• Iso-Eremfat;
• Isoniazid;
• Capreomycin;
• Coxerin;
• Combine Neo;
• Lemodus;
• Polcortolone;
• Resonizant;
• Resonisate plus;
• Rifakomb;
• Phtivazide;
• Eremfat;
• Ethambutol.

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