What is Streptomycin?
Streptomycin is an
antibiotic that belongs to the aminoglycoside class of antibiotics, which are used to treat various bacterial infections. It was the first antibiotic discovered to be effective against
tuberculosis and is derived from the bacterium Streptomyces griseus. Streptomycin works by inhibiting protein synthesis in bacteria, thereby preventing their growth and reproduction.
What Infections Does Streptomycin Treat?
Streptomycin is primarily used to treat tuberculosis, particularly in cases where the patient is resistant to other first-line drugs. It is also used to treat infections caused by
gram-negative bacteria such as Yersinia pestis (plague), Francisella tularensis (tularemia), and Brucella (brucellosis). In some cases, it may be used in combination with other antibiotics to treat endocarditis caused by enterococci.
How is Streptomycin Administered?
Streptomycin is usually administered via
intramuscular injection. The dosage and duration of treatment depend on the type and severity of the infection, as well as the patient's response to the medication. It is important for healthcare providers to monitor patients closely for side effects and adjust the dosage as necessary.
What are the Side Effects of Streptomycin?
Common side effects of streptomycin include dizziness, vertigo, and injection site reactions. More serious side effects can occur, such as
ototoxicity (damage to the ears), nephrotoxicity (kidney damage), and neurotoxicity (nerve damage). Patients receiving streptomycin should be monitored for these adverse effects, especially if they are receiving prolonged treatment or higher doses.
What are the Mechanisms of Resistance?
Bacterial resistance to streptomycin can develop through several mechanisms. These include mutations in the bacterial ribosomal RNA that prevent streptomycin from binding effectively, the enzymatic modification of streptomycin by bacterial enzymes, and the efflux of the drug out of the bacterial cell. Resistance is a major concern in the treatment of tuberculosis, which is why streptomycin is often used in combination with other
antimicrobial agents to reduce the risk of resistance development.
What are the Alternatives to Streptomycin?
For patients who cannot tolerate streptomycin or when resistance is a concern, alternative aminoglycosides such as
gentamicin and
amikacin may be used. Other classes of antibiotics, like fluoroquinolones or macrolides, might also be considered depending on the infection being treated. The choice of alternative therapy should be guided by the sensitivity profile of the infecting organism and the patient's clinical condition.
What are the Considerations for Use in Special Populations?
Streptomycin use in
pregnancy should be approached with caution due to potential risks to the fetus, including ototoxicity. In pediatric patients, dosage adjustments are necessary to prevent toxicity. Elderly patients may also require dose modifications due to age-related renal function decline. It is crucial to assess renal function before and during treatment with streptomycin to minimize the risk of nephrotoxicity.
Conclusion
Streptomycin remains a valuable antibiotic in the treatment of certain infectious diseases, particularly tuberculosis and other serious infections caused by gram-negative bacteria. Its use, however, is limited by potential side effects and the risk of resistance development. Careful patient selection, appropriate dosing, and monitoring are essential to maximize the benefits and minimize the risks associated with streptomycin therapy.
