Parenteral Manual

Streptomycin sulfate (NON-FORMULARY)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Classification: 
Aminoglycoside Antibiotic
Original Date: 
April 2008
Revised Date: 
Indications: 
  • Treatment of tuberculosis in combination with other agents
  • Treatment of tularemia, plague, brucellosis
Reconstitution and Stability: 
VIAL SIZE SWFI REQUIRED FINAL CONCENTRATION
1000 mg 4.2 mL 200 mg/mL
  • Powder  stable at room temperature
  • Reconstituted vial stable 1 week at room temperature- Protect from light
  • Diluted solutions stable 24 hours at room temp -Protect from light
     
Compatibility: 

-Solutions Compatible:  D5W, NS

-Additive/buretrol Compatible:  no information

-Y-site Compatible:  Esmolol

-Incompatible:  Amphotericin B, heparin, norepinephrine, phenobarbital, phenytoin, sodium bicarbonate

 

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM YES -deep into large muscle mass
IV Push NO
IV Intermittent Infusion

YES
-Usual dilution - in 100 mL NS or D5W
-Infusion time -  30 - 60 minutes 

IV Continuous Infusion NO

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

  • Tuberculosis:  20 - 40 mg/kg once daily , not to exceed 1 g/day

Adult:

  • Tuberculosis:  15 mg/kg once daily , not to exceed 1 g/day
  • Tularemia:  1 - 2 g IM Q12H for 7-10 days or until patient afebrile for 5-7 days
  • Plague: 1 g IM Q12H for 10 - 14 days or until patient afebrile 3 days
  • Brucellosis: 1 - 2 g IM once or twice daily  -max 2 g/day

DOSING ADJUSTMENT IN RENAL IMPAIRMENT:

  • Adjust dose and/or interval  based on serum concentrations
Potential hazards of parenteral administration: 
  • Ototoxicity:  vestibular (nausea,vomiting, vertigo) and cochlear (tinnitus,hearing loss) toxicity
  • Nephrotoxicity
  • Allergic reactions:  anaphylaxis, itching, rash, urticaria
  • Facial paresthesia
  • Nausea, vomiting
  • Potential for neuromuscular blockade (rare)
  • If patient experiences tingling or dizziness during the infusion, slowing the duration of infusion to 60 minutes tends to alleviate this problem
Notes: 
  • Use with caution in patients with pre-existing renal, vestibular or auditory impairment, or neuromuscular disorders
  • Adverse effects potentiated by other ototoxic and nephrotoxic drugs
  • Apnea may result when combined with anesthetic or other neuromuscular blocking drugs
  • Monitor urinalysis, urine output, BUN,  SCr, serum drug levels, audiology

Therapeutic Drug Monitoring:
-Therapeutic Serum Concentration-  trough:  < 5 mg/L
                                                               -  peak:  15 - 40 mg/L

References: 

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.