Streptomycin 0.75gm Powder Dilution for IM Administration
For intramuscular administration of Streptomycin 0.75gm powder, dilute with 2.5-3.0 mL of sterile water for injection to achieve an appropriate concentration for IM use.
Dilution Guidelines
The appropriate dilution of streptomycin powder is critical for proper administration and patient safety. According to the FDA drug label for streptomycin, the following dilution guidelines should be followed 1:
- For 0.75gm of streptomycin powder (which falls between the 0.5g and 1g standard doses):
- Use approximately 2.5-3.0 mL of sterile water for injection
- This will yield a concentration of approximately 250-300 mg/mL
Administration Considerations
Injection Site
- Adults: The preferred site is the upper outer quadrant of the buttock (gluteus maximus) or the mid-lateral thigh 1
- Children: Mid-lateral muscles of the thigh are recommended 1
Important Administration Techniques
- Aspirate before injection to avoid inadvertent intravascular administration
- Alternate injection sites for repeated doses
- Administer slowly to minimize patient discomfort
Monitoring Requirements
When administering streptomycin, careful monitoring is essential due to potential toxicity:
Renal function monitoring:
- First month: twice weekly
- Second month: weekly
- Third month onward: every 2 weeks 2
Auditory and vestibular monitoring:
- Baseline audiometry before starting therapy
- Monthly audiometry during treatment
- Final audiometry 2 months after completing treatment 2
Potential Adverse Effects
Be vigilant for signs of toxicity, which may include:
- Ototoxicity (hearing loss, tinnitus, vertigo)
- Nephrotoxicity
- Neuromuscular blockade
Special Considerations
- For patients >59 years: Consider reduced dosing (10 mg/kg daily, maximum 750 mg daily) 2
- For patients with renal impairment: Dose adjustment is required (12-15 mg/kg two to three times weekly) 2
- For obese patients: Use ideal body weight plus 40% of excess weight for dosing calculations 2
Important Cautions
- Streptomycin is approved for intramuscular administration only, though there are reports of intravenous use in specific circumstances 3, 4
- Avoid excessive dilution as it may increase the volume beyond what is comfortable for IM injection
- Reconstituted solutions should be protected from light and may be stored at room temperature for up to one week without significant loss of potency 1
Always inspect the reconstituted solution for particulate matter and discoloration prior to administration.