What are the indications, dosing regimens, and monitoring recommendations for intramuscular streptomycin?

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Streptomycin Injection: Clinical Guide

Primary Indications

Streptomycin is primarily indicated for tuberculosis (as part of multidrug regimens when drug resistance is suspected), plague, tularemia, bacterial endocarditis (streptococcal and enterococcal), and as a second-line agent for other serious gram-negative infections. 1

Dosing Regimens

Tuberculosis

For drug-susceptible TB with suspected resistance, streptomycin dosing varies by frequency:

Adults:

  • Daily: 15 mg/kg IM once daily (maximum 1 g/day) 2, 1
  • Twice weekly: 25-30 mg/kg (maximum 1.5 g) 1
  • Thrice weekly: 25-30 mg/kg (maximum 1.5 g) 1
  • Age >59 years: Reduce to 10 mg/kg daily (maximum 750 mg) due to increased toxicity risk 3, 2

Children:

  • Daily: 20-40 mg/kg (maximum 1 g/day) 2, 1
  • Twice/thrice weekly: 25-30 mg/kg (maximum 1.5 g) 1

Treatment duration: Usually given daily for the first 1-2 months, then frequency may be reduced to 2-3 times weekly 3. Total cumulative dose should not exceed 120 g unless no other therapeutic options exist 1.

Plague

Adults: 2 g daily IM in two divided doses for minimum 10 days 1

Tularemia

**Adults: 1-2 g daily IM in divided doses for 7-14 days until afebrile for 5-7

References

2
Guideline

treatment of tuberculosis.

MMWR Recommendations and Reports, 2003

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.