Spectrum Of Activity
Age <50y 15 mg/kg IM q24h (max 1 g)
Age ≥50y 10 mg/kg IM q24h (max 750 mg) 목동병원에서만 사용함
Age >2y: 20-40 mg/kg IM q24h목동병원에서만 사용함
No dose adjustment
CrCl 90CrCl 70CrCl 50CrCl 30CrCl 20CrCl 10CrCl 0HD15 mg/kg IV q24h12 mg/kg IV q24h7.5 mg/kg IV q24h4 mg/kg IV q24h7.5 mg/kg IV q48h4 mg/kg IV q48h3 mg/kg IV q48h3 mg/kg IV q48h after HD
H. influenzae infection
Infection due to Mycobacterium tuberculosis
Sepsis due to gram-negative bacteria
Urinary tract infectious disease
Black Box Warning:
The risk of severe neurotoxic reactions is sharply increased in patients with impaired renal function or prerenal azotemia. The incidence of clinically detectable, irreversible vestibular damage is particularly high in patients treated with streptomycin.
Patients with renal impairment and/or nitrogen retention should receive reduced doses.
The neurotoxicity of streptomycin can result in respiratory paralysis from neuromuscular blockage, especially when the drug is given soon after the use of anesthesia or muscle relaxants.
Obtain serum creatinine renal function levels at baseline and monthly.
Monitor serum drug concentrations, particularly in patients with renal impairment or receiving hemodialysis, and potentially in patients receiving peritoneal dialysis.
Obtain acid-fast bacilli smear and culture until 2 consecutive culture specimens are negative.
Perform chest x-rays after 2 months of treatment.
Respiratory tract paralysis - concomitant anesthesia, muscle relaxants
- Ataluren- may result in decrased activity and increased risk of nephrotoxicity
Major drug-drug interactions:
Nondepolarizing neuromuscular blockers
Avoid concurrent or sequential use:
Antimicrobial class: Aminoglycoside, Antitubercular
Pregnancy category: D
Average serum half life: 5-6 hours
Use extreme caution in patients with renal insufficiency as a single dose in severely uremic patients may produce ototoxic sequelae; dose adjustment required.
Urine alkalinization may minimize or prevent renal irritation when prolonged therapy is necessary.
Vestibular and auditory dysfunction may occur; increased risk with higher dosage, longer treatment duration, renal insufficiency, underlying existing auditory dysfunction, and coadministration of ethacrynic acid, mannitol, furosemide and other diuretics; monitoring recommended and early discontinuation may be necessary.
Monitoring recommended in infants.