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): 
Aminoglycoside Antibiotic
Original Date: 
April 2008
Revised Date: 
  • Treatment of tuberculosis in combination with other agents
  • Treatment of tularemia, plague, brucellosis
Reconstitution and Stability: 
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

-Solutions Compatible:  D5W, NS

-Additive/buretrol Compatible:  no information

-Y-site Compatible:  Esmolol

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



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

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

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

IV Continuous Infusion NO



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


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


  • 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


  • 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
  • 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


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