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STREPTOMYCIN:A major disadvantage and cause of failure of streptomycin therapy is the development of bacterial resistance especially when used over a long period. The addition of other antitubercula drugs reduce the speed with which bacteria become resistant to streptomycin, it is absorbed very well and rapidly from I’m. and subcutaneous sites. Drug is distributed in all the extra cellular fluids and about one third in plasma is bound to protein.

Indication:Plague, tuberculosis, tularemia, sub acute bacterial endocarditic, meningitis, brucellosis.

Dosage :The single dose of streptomycin is usually 1mg/day for 2 to 3 months in severe forms of tuberculosis, such as meningitis and disseminated disease, followed by 1 gm two to three times weekly for remainder period of treatment.

Contra-indications:Diseases of ear, particularly supportive obits-media, labyrinthine disturbances.

Special Precautions:Impaired liver or kidney function, premature infants, possibility of resistance, skin sensitization and impairment of vestibular and auditory functions.

Pediatrics: Contraindicated.
Pregnancy: Contraindicated.
Lactation: Contracted
Elderly: Reduced dose necessary.

Side-effects: Anaphylactic shock, nephrotoxicity. Ototoxicity, skin -rash, fever plastic anemia andagranulocytosis, ataxia, eosinopillia, optic nerve dysfunction.

Drug interaction: Potentates nephrotoxicity produced by other amino glycosides, cancomycin and some cephalosporins. Potentate ototoxicity produced by other amino glycosides and ethacryanic acid. Plasma levels increased by indomethacin, H1 alkalis. Synergism with bezylpenicilline.