Streptomycin indications and usage: Difference between revisions

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====Mycobacterium tuberculosis====
====Mycobacterium tuberculosis====


The Advisory Council for the Elimination of [[Tuberculosis]], the [[American Thoracic Society]], and the [[Center for Disease Control]] recommend that either streptomycin or ethambutol be added as a fourth drug in a regimen containing [[isoniazid]] ([[INH]]), [[rifampin]] and [[pyrazinamide]] for initial treatment of [[tuberculosis]] unless the likelihood of [[INH]] or [[rifampin]] resistance is very low. The need for a fourth drug should be reassessed when the results of susceptibility testing are known. In the past when the national rate of primary drug resistance to isoniazid was known to be less than 4% and was either stable or declining, therapy with two and three drug regimens was considered adequate. If community rates of [[INH]] resistance are currently less than 4%, an initial treatment regimen with less than four drugs may be considered.                                             
The Advisory Council for the Elimination of [[Tuberculosis]], the [[American Thoracic Society]], and the [[Center for Disease Control]] recommend that either streptomycin or ethambutol be added as a fourth drug in a regimen containing [[isoniazid]] ([[INH]]), [[rifampin]] and [[pyrazinamide]] for initial treatment of [[tuberculosis]] unless the likelihood of [[INH]] or [[rifampin]] resistance is very low. The need for a fourth drug should be reassessed when the results of [[susceptibility]] testing are known. In the past when the national rate of primary drug resistance to isoniazid was known to be less than 4% and was either stable or declining, therapy with two and three drug regimens was considered adequate. If community rates of [[INH]] resistance are currently less than 4%, an initial treatment regimen with less than four drugs may be considered.                                             


Streptomycin is also indicated for therapy of [[tuberculosis]] when one or more of the above drugs is contraindicated because of toxicity or intolerance. The management of tuberculosis has become more complex as a consequence of increasing rates of drug resistance and concomitant HIV infection. Additional consultation from experts in the treatment of tuberculosis may be desirable in those settings.
Streptomycin is also indicated for therapy of [[tuberculosis]] when one or more of the above drugs is contraindicated because of toxicity or intolerance. The management of tuberculosis has become more complex as a consequence of increasing rates of drug resistance and concomitant HIV infection. Additional consultation from experts in the treatment of tuberculosis may be desirable in those settings.

Revision as of 17:59, 7 January 2014

Streptomycin
STREPTOMYCIN® FDA Package Insert
Description
Clinical Pharmacology
Microbiology
Indications and Usage
Contraindications
Warnings and Precautions
Adverse Reactions
Drug Interactions
Dosage and Administration
How Supplied
Labels and Packages

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Indications and Usage

Streptomycin is indicated for the treatment of individuals with moderate to severe infections caused by susceptibile strains of microorganisms in the specific conditions listed below:

Mycobacterium tuberculosis

The Advisory Council for the Elimination of Tuberculosis, the American Thoracic Society, and the Center for Disease Control recommend that either streptomycin or ethambutol be added as a fourth drug in a regimen containing isoniazid (INH), rifampin and pyrazinamide for initial treatment of tuberculosis unless the likelihood of INH or rifampin resistance is very low. The need for a fourth drug should be reassessed when the results of susceptibility testing are known. In the past when the national rate of primary drug resistance to isoniazid was known to be less than 4% and was either stable or declining, therapy with two and three drug regimens was considered adequate. If community rates of INH resistance are currently less than 4%, an initial treatment regimen with less than four drugs may be considered.

Streptomycin is also indicated for therapy of tuberculosis when one or more of the above drugs is contraindicated because of toxicity or intolerance. The management of tuberculosis has become more complex as a consequence of increasing rates of drug resistance and concomitant HIV infection. Additional consultation from experts in the treatment of tuberculosis may be desirable in those settings.

Non-tuberculosis infections

The use of streptomycin should be limited to the treatment of infections caused by bacteria which have been shown to be susceptible to the antibacterial effects of streptomycin and which are not amenable to therapy with less potentially toxic agents.

  • H. influenzae (in respiratory, endocardial, and meningeal infections-concomitantly with another antibacterial agent)
  • K. pneumoniae pneumonia (concomitantly with another antibacterial agent)

To reduce the development of drug-resistant bacteria and maintain the effectiveness of streptomycin and other antibacterial drugs, streptomycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.[1]

References

  1. "STREPTOMYCIN INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION [X-GEN PHARMACEUTICALS, INC.]".

Adapted from the FDA Package Insert.