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streptomycin
generic
Black Box Warnings .
Appropriate Use
admin. only where adequate laboratory and audiometric testing available during tx
Neurotoxicity/Ototoxicity
incr. risk w/ renal impairment or pre-renal azotemia; severe rxns incl. vestibular and cochlear fxn disturbances, optic nerve dysfxn, peripheral neuritis, arachnoiditis, encephalopathy; high incidence of clinically detectable, irreversible vestibular damage in pts receiving streptomycin; pts w/ renal impairment and/or nitrogen retention should receive lower doses; monitor renal fxn; avoid concurrent and/or sequential neurotoxic and/or nephrotoxic agents
Neuromuscular Blockade
neuromuscular blockade incl. resp. paralysis may occur, esp. when given soon after anesthesia or muscle relaxants
Adult Dosing .
Dosage forms: INJ
tuberculosis, active
- [<59 yo, intensive phase]
- Dose: 15 mg/kg/dose IM/IV 5-7x/wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts
- [<59 yo, continuation phase]
- Dose: 15 mg/kg/dose IM/IV 2-3x/wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts
- [59 yo and older, intensive phase]
- Dose: 10 mg/kg/dose IM/IV 5-7x/wk; Max: 750 mg/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts
- [59 yo and older, continuation phase]
- Dose: 10 mg/kg/dose IM/IV 2-3x/wk; Max: 750 mg/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion; use adjusted wt of IBW + 0.4 x (ABW - IBW) in obese pts
enterococcal endocarditis
- [15 mg/kg/day IM/IV divided bid x4-6wk]
- Info: not 1st-line agent; part of multi-drug regimen; use IBW
plague
- [15 mg/kg/dose IM q12h x10 days]
- Max: 1 g/dose
tularemia
- [7.5-15 mg/kg/dose IM q12h x10 days]
- Max: 2 g/day
brucellosis (off-label)
- [1 g IM q24h x2-3wk]
- Info: part of multi-drug regimen
renal dosing
- [tuberculosis intensive phase]
- CrCl <30: give usual dose 2-3x/wk
- HD: give usual dose 2-3x/wk after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined
- [tuberculosis continuation phase]
- renal impairment: not defined
- HD/PD: not defined
- [enterococcal endocarditis]
- CrCl <50: avoid use
- HD/PD: not defined
- [all other indications]
- CrCl 10-50: give usual dose q24-72h; CrCl <10: give usual dose q72-96h
- HD: give usual dose 2-3x/wk after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ
tuberculosis, active
- [intensive phase]
- Dose: 20-40 mg/kg/dose IM/IV 5-7x/wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion
- [continuation phase]
- Dose: 20-40 mg/kg/dose IM/IV 2-3x/wk; Max: 1 g/dose; Info: not 1st-line agent; part of multi-drug regimen; duration depends on susceptibility and culture conversion
plague
- [15 mg/kg/dose IM q12h x10 days]
- Max: 2 g/day
tularemia
- [15 mg/kg/dose IM q12h x10 days]
- Max: 2 g/day
brucellosis (off-label)
- [8 yo and older]
- Dose: 15 mg/kg/dose IM q24h x2-3wk; Max: 1 g/day; Info: part of multi-drug regimen
renal dosing
- [tuberculosis]
- renal impairment: not defined, consider adult renal dosing for guidance
- HD/PD: not defined, consider adult renal dosing for guidance
- [all other indications]
- CrCl 10-50: give usual dose q24-72h; CrCl <10: give usual dose q72-96h
- HD: give usual dose 2-3x/wk after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined
hepatic dosing
- [not defined]