streptomycin

(strĕp'tə-mī'sĭn)

[STREPTOMYC(ES) + -IN.]

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For more information on streptomycin, visit Britannica.com.

Chemical formula:

Espa�ol:
• Sulfato de estreptomicina, Solución para inyección

Streptomycin Sulfate Solution for injection

What is this medicine?

STREPTOMYCIN (strep toe MYE sin) is an aminoglycoside antibiotic. It is used to treat certain kinds of bacterial infections. It will not work for colds, flu, or other viral infections.
 
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•hearing problems
•kidney disease
•an unusual or allergic reaction to streptomycin, other aminoglycosides or medicines, sulfites, foods, dyes or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

This medicine is for injection into a muscle. It is usually given by a health care professional in a hospital or clinic setting.

If you get this medicine at home, you will be taught how to prepare and give this medicine. Use exactly as directed. Take your medicine at regular intervals. Do not take your medicine more often than directed.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or healthcare provider to get one.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for selected conditions, precautions do apply

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

What may interact with this medicine?

Do not take this medicine with any of the following medications:
•cephaloridine
•cidofovir
•colistin
•cyclosporine
•other aminoglycoside antibiotics
•polymyxin
•viomycin

This medicine may also interact with the following medications:
•anesthesia drugs
•diuretics
•muscle relaxers

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Tell your doctor or health care professional if your symptoms do not start to get better or if they get worse. Your condition, including your hearing and lab work, will be monitored while you are taking this medicine.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•breathing problems
•change in amount or color of urine
•change in hearing
•fever
•loss of balance
•pain, tingling, numbness in the hands or feet
•redness, blistering, peeling or loosening of the skin, including inside the mouth
•unusual bleeding or bruising
•unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•headache
•nausea, vomiting
•pain or swelling at site where injected

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

This drug is given in a hospital or clinic and will not be stored at home.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Tutor's tip: This word was used in the 2006 Scripps National Spelling Bee finals.

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One of the oldest of the aminoglycoside antibiotics. Because of its widespread use many previously susceptible gram-negative bacteria have developed a resistance to it and it has lost a great deal of its effectiveness and popularity. It is most effective against leptospira and haemophilus-associated infections. Like all other members of the group, streptomycin is absorbed poorly from the alimentary tract and must be given parenterally, usually by intramuscular injection for systemic effect. The group has moderate toxicity but this is of minor importance in food animals. Even in companion animals the risk is small but deafness and vestibular disturbances can occur, particularly in cats. Dihydrostreptomycin is a derivative and is used as an alternative to the parent antibiotic.

An antimicrobial drug often used to treat infections caused by gramnegative bacteria (such as tuberculosis). Though no human studies have been conducted, streptomycin administered during pregnancy or breastfeeding may cause damage to the ear of the fetus or infant.

• PHARMACOLOGY - streptomycin: antibiotic used esp. to treat tuberculosis

Streptomycin

Systematic (IUPAC) name
5-(2,4-diguanidino- 3,5,6-trihydroxy-cyclohexoxy)- 4-[4,5-dihydroxy-6-(hydroxymethyl) -3-methylamino-tetrahydropyran-2-yl] oxy-3-hydroxy-2-methyl -tetrahydrofuran-3-carbaldehyde
Clinical data
AHFS/Drugs.com	monograph
Pregnancy cat.	DM[1]
Legal status	POM (UK) ℞-only (US)
Routes	Intramuscular, intravenous
Pharmacokinetic data
Bioavailability	84% to 88% (est.)[2]
Half-life	5 to 6 hours
Excretion	Renal
Identifiers
CAS number	57-92-1 Y
ATC code	A07AA04 J01GA01
PubChem	CID 19649
DrugBank	DB01082
ChemSpider	18508 Y
UNII	Y45QSO73OB Y
KEGG	D08531 Y
ChEBI	CHEBI:17076 Y
ChEMBL	CHEMBL1201194 N
NIAID ChemDB	AIDSNO:07346
Chemical data
Formula	C21H39N7O12
Mol. mass	581.574 g/mol
SMILES	eMolecules & PubChem
InChI InChI=1S/C21H39N7O12/c1-5-21(36,4-30)16(40-17-9(26-2)13(34)10(31)6(3-29)38-17)18(37-5)39-15-8(28-20(24)25)11(32)7(27-19(22)23)12(33)14(15)35/h4-18,26,29,31-36H,3H2,1-2H3,(H4,22,23,27)(H4,24,25,28)/t5-,6-,7+,8-,9-,10-,11+,12-,13-,14+,15+,16-,17-,18-,21+/m0/s1 Y Key:UCSJYZPVAKXKNQ-HZYVHMACSA-N Y
Physical data
Melt. point	12 °C (54 °F)
N(what is this?)  (verify)

Streptomycin is an antibiotic drug, the first of a class of drugs called aminoglycosides to be discovered, and was the first antibiotic remedy for tuberculosis. It is derived from the actinobacterium Streptomyces griseus. Streptomycin is a bactericidal antibiotic.^[3] Streptomycin cannot be given orally, but must be administered by regular intramuscular injections. An adverse effect of this medicine is ototoxicity. It is not to be confused with the anti-thrombotic agent streptokinase.

Contents 1 Mechanism of action 2 History 3 Uses 3.1 Treatment of diseases 3.2 Pesticide 3.3 Cell culture 4 See also 5 References 6 Further reading

Mechanism of action

Streptomycin is a protein synthesis inhibitor. It binds to the small 16S rRNA of the 30S subunit of the bacterial ribosome, interfering with the binding of formyl-methionyl-tRNA to the 30S subunit.^[4] This leads to codon misreading, eventual inhibition of protein synthesis and ultimately death of microbial cells through mechanisms that are still not understood. Speculation on this mechanism indicates that the binding of the molecule to the 30S subunit interferes with 50S subunit association with the mRNA strand. This results in an unstable ribosomal-mRNA complex, leading to a frameshift mutation and defective protein synthesis; leading to cell death.^[5] Humans have structurally different ribosomes from bacteria, thereby allowing the selectivity of this antibiotic for bacteria. However at low concentrations Streptomycin only inhibits growth of the bacteria by inducing prokaryotic ribosomes to misread mRNA.^[6] Streptomycin is an antibiotic that inhibits both Gram-positive and Gram-negative bacteria,^[7] and is therefore a useful broad-spectrum antibiotic.

History

Streptomycin was first isolated on October 19, 1943 by Albert Schatz, a graduate student, in the laboratory of Selman Abraham Waksman at Rutgers University.^[8] Dr. Waksman and his laboratory discovered several antibiotics, including actinomycin, clavacin, streptothricin, streptomycin, grisein, neomycin, fradicin, candicidin and candidin. Of these, streptomycin and neomycin found extensive application in the treatment of numerous infectious diseases. Streptomycin was the first antibiotic that could be used to cure the disease tuberculosis; early production of the drug was dominated by Merck & Co. under George W. Merck.

The first randomized trial of streptomycin against pulmonary tuberculosis was carried out in 1946-1947 by the MRC Tuberculosis Research Unit under the chairmanship of Sir Geoffrey Marshall (1887–1982). The trial was both double-blind and placebo-controlled. It is widely accepted to have been the first randomised curative trial.^[9] Results showed efficacy against TB, albeit with minor toxicity and acquired bacterial resistance to the drug.^[10]

Uses

Treatment of diseases

• Infective endocarditis caused by enterococcus when the organism is not sensitive to Gentamicin
• Tuberculosis in combination with other anti-TB drugs. It is not the first-line treatment, except in medically under-served populations where the cost of more expensive treatments is prohibitive.
• Plague (Yersinia pestis) has historically been treated with it as the first-line treatment. It is approved for this purpose by the U.S. Food and Drug Administration.
• In veterinary medicine, streptomycin is the first-line antibiotic for use against gram negative bacteria in large animals (horses, cattle, sheep etc.). It is commonly combined with procaine penicillin for intramuscular injection.

While streptomycin is traditionally given intramuscularly (indeed, in many countries it is only licensed to be used intramuscularly), the drug may also be administered intravenously.^[2]

Pesticide

Streptomycin is also used as a pesticide, to combat the growth of bacteria, fungi, and algae. Streptomycin controls bacterial and fungal diseases of certain fruit, vegetables, seed, and ornamental crops, and controls algae in ornamental ponds and aquaria. A major use is in the control of fireblight on apple and pear trees. As in medical applications, extensive use can be associated with the development of resistant strains.

Cell culture

Streptomycin, in combination with penicillin, is used in a standard antibiotic cocktail to prevent bacterial infection in cell culture.

See also

• Philip D'Arcy Hart - The British medical researcher and pioneer in tuberculosis treatment in the early 20th century.

References

1. ^ "Taking Streptomycin during pregnancy and breastfeeding". Drug Safety Site. 2006. http://drugsafetysite.com/streptomycin. Retrieved 2010-05-25. 
2. ^ ^{a b} Zhu M, Burman WJ, Jaresko GS, Berning SE, Jelliffe RW, Peloquin CA. (October 2001). "Population pharmacokinetics of intravenous and intramuscular streptomycin in patients with tuberculosis". Pharmacotherapy 21 (9): 1037–1045. doi:10.1592/phco.21.13.1037.34625. PMID 11560193. http://www.medscape.com/viewarticle/409778. Retrieved 2010-05-25. 
3. ^ Singh B, Mitchison DA (16 January 1954). "Bactericidal Activity of Streptomycin and Isoniazid Against Tubercle Bacilli". British Medical Journal 1 (4854): 130–132. doi:10.1136/bmj.1.4854.130. PMC 2084433. PMID 13106497. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2084433. 
4. ^ Sharma D, Cukras AR, Rogers EJ, Southworth DR, Green R (7 December 2007). "Mutational analysis of S12 protein and implications for the accuracy of decoding by the ribosome". Journal of Molecular Biology. 
5. ^ Raymon, Lionel P. (2011). COMLEX Level 1 Pharmacology Lecture Notes. Miami, FL: Kaplan, Inc.. pp. 181. ISBN CM4024K. 
6. ^ Voet, Donald & Voet, Judith G. (2004). Biochemistry (3rd ed.). John Wiley & Sons. p. 1341. ISBN 0-471-19250-X. 
7. ^ Jan-Thorsten Schantz; Kee-Woei Ng (2004). A manual for primary human cell culture. World Scientific. p. 89. 
8. ^ Comroe JH Jr (1978). "Pay dirt: the story of streptomycin. Part I: from Waksman to Waksman". American Review of Respiratory Disease 117 (4): 773–781. PMID 417651. 
9. ^ Metcalfe NH, Sir Geoffrey Marshall (1887-1982), Journal of Medical Biography 2011; 19: 10-14.
10. ^ D'Arcy Hart, Philip (28 August 1999). "A change in scientific approach: from alternation to randomised allocation in clinical trials in the 1940s". British Medical Journal. 

Further reading

• Kingston, William (2004). "Streptomycin, Schatz v. Waksman, and the Balance of Credit for Discovery". Journal of the History of Medicine and Allied Sciences 59 (3): 441–462. doi:10.1093/jhmas/jrh091. PMID 15270337 
• Mistiaen, Veronique (2 November 2002). "Time, and the great healer". The Guardian. http://www.guardian.co.uk/weekend/story/0,3605,823114,00.html . The history behind the discovery of streptomycin.
• EPA R.E.D. Facts sheet on use of streptomycin as a pesticide.

v d e Antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07) Rehydration Oral rehydration therapy Intestinal anti-infectives Antibiotics (Neomycin Nystatin Natamycin Streptomycin Polymyxin B Paromomycin Amphotericin B Kanamycin Vancomycin Colistin Rifaximin) Sulfonamides (Phthalylsulfathiazole Sulfaguanidine Succinylsulfathiazole) Nitrofuran (Nifuroxazide Nifurzide) Imidazole (Miconazole) Arsenical (Acetarsol) Oxyquinoline (Broxyquinoline) Intestinal adsorbents Charcoal Bismuth Pectin Kaolin Crospovidone Attapulgite Diosmectite Antipropulsives (opioids) Opium Tincture (Laudanum) Codeine Morphine Camphorated Opium Tincture (Paregoric) crosses BBB: Diphenoxylate (Diphenoxylate/atropine) Difenoxin does not cross BBB: Loperamide Intestinal anti-inflammatory agents corticosteroids acting locally (Prednisolone Hydrocortisone Prednisone Betamethasone Tixocortol Budesonide Beclometasone) antiallergic agents, excluding corticosteroids (Cromoglicic acid) aminosalicylic acid and similar agents (Sulfasalazine Mesalazine Olsalazine Balsalazide) Antidiarrheal micro-organisms Saccharomyces boulardii Other antidiarrheals Albumin tannate Ceratonia Octreotide Racecadotril M: DIG anat(t, g, p)/phys/devp/enzy noco/cong/tumr, sysi/epon proc, drug(A2A/2B/3/4/5/6/7/14/16), blte

v d e Antibacterials: protein synthesis inhibitors (J01A, J01B, J01F, J01G, QJ01XQ) 30S Aminoglycosides (initiation inhibitors) -mycin (Streptomyces) Streptomycin# Neomycin# Framycetin Paromomycin Ribostamycin Kanamycin# Amikacin Arbekacin Bekanamycin Dibekacin Tobramycin Spectinomycin# Hygromycin B Paromomycin -micin (Micromonospora) Gentamicin# Netilmicin Sisomicin Isepamicin Verdamicin Astromicin Tetracycline antibiotics (tRNA binding) Tetracyclines Doxycycline# Chlortetracycline Clomocycline Demeclocycline Lymecycline Meclocycline Metacycline Minocycline Oxytetracycline Penimepicycline Rolitetracycline Tetracycline Glycylcyclines Tigecycline 50S Oxazolidinone (initiation inhibitors) Linezolid Torezolid Eperezolid Posizolid Radezolid Peptidyl transferase Amphenicols Chloramphenicol# Azidamfenicol Thiamphenicol Florfenicol Pleuromutilins Retapamulin Tiamulin Valnemulin MLS (transpeptidation/translocation) Macrolides Erythromycin# Azithromycin# Spiramycin Midecamycin Oleandomycin Roxithromycin Josamycin Troleandomycin Clarithromycin Miocamycin Rokitamycin Dirithromycin Flurithromycin Ketolide Telithromycin Cethromycin Solithromycin Lincosamides Clindamycin# Lincomycin Streptogramins Pristinamycin Quinupristin/dalfopristin Virginiamycin EF-G Steroid antibacterials Fusidic acid #WHO-EM ‡Withdrawn from market Clinical trials: †Phase III §Never to phase III M: BAC bact (clas) gr+f/gr+a(t)/gr-p(c)/gr-o drug(J1p, w, n, m, vacc)

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