streptomycin

[STREPTOMYC(ES) + -IN.]

For more information on streptomycin, visit Britannica.com.

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.

Chemical formula:

Español:
• Sulfato de estreptomicina, Solución para inyección

Streptomycin Sulfate Solution for injection

What is this medicine?

STREPTOMYCIN 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.

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.

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

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
Identifiers
CAS number	57-92-1
ATC code	A07AA04 J01GA01
PubChem	5999
DrugBank	APRD00412
ChemSpider	18508
Chemical data
Formula	C21H39N7O12
Mol. mass	581.574 g/mol
Physical data
Melt. point	12 °C (54 °F)
Pharmacokinetic data
Bioavailability	84% to 88% (est.)[1]
Metabolism	?
Half life	5 to 6 hours
Excretion	Renal
Therapeutic considerations
Pregnancy cat.	D[2]
Legal status	POM(UK) ℞-only(US)
Routes	Intramuscular, intravenous

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, which can lead to hearing loss.

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

Mechanism of action

Streptomycin is a protein synthesis inhibitor. It binds to the S12 Protein of the 30S subunit of the bacterial ribosome, interfering with the binding of formyl-methionyl-tRNA to the 30S subunit.^{[citation needed]} This prevents initiation of protein synthesis and leads to death of microbial cells. 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, this is done by inducing prokaryotic ribosomes to misread mRNA.^[4].

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.^[5] 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 1947 by the MRC Tuberculosis Research Unit. Whilst neither double-blind nor placebo-controlled, results showed efficacy against TB, albeit with minor toxicity and acquired bacterial resistance to the drug.^[6]

Uses

Treatment of diseases

• 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 are 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.
• Infective endocarditis caused by enterococcus when the organism is not sensitive to Gentamicin
• 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.^[7]

Bacteria selection experiments

When grown on a medium containing streptomycin, bacteria such as Escherichia coli are dependent upon expression of the aadA gene in order to survive (Joung et al., 2000). Thus, a suitably engineered E. coli strain, can be combined with a streptomycin-doped medium to select only bacteria hosting a successful interaction in two-hybrid screening experiments and methods derivative of two-hybrid screening (Hurt et al., 2003; Joung et al., 2000) Streptomycin is an antibiotic that inhibits both gram positive and gram negative bacteria, and is a therefore a useful broad spectrum antibiotic.

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.

See also

• Philip D'Arcy Hart

References

1. ^ "Streptomycin in Patients with Tuberculosis." Pharmacotherapy 21(9):1037-1045, 2001. Retrieved on July 7, 2008.
2. ^ "Streptomycin in pregnancy and breastfeeding: Drug safety." Drug Safety Site, 2006. Retrieved on July 7, 2008.
3. ^ Singh B., Mitchison, D.A. (1954). "Bactericidal activity of streptomycin and isoniazid against tubercle bacilli". British Medical Journal 1 (4854): 130–2. doi:10.1136/bmj.1.4854.130. PMID 13106497. PMID 13106497. 
4. ^ Donald Voet and Judith G. Voet, Biochemistry 3rd edition, 2004, page 1341, ISBN 0-471-19250-x (cloth)
5. ^ Comroe JH (1978). "Pay dirt: the story of streptomycin. Part I: from Waksman to Waksman". Am Rev Respir Dis 117 (4): 773–781. PMID 417651. 
6. ^ D'Arcy Hart P (August 1999). "A change in scientific approach: from alternation to randomised allocation in clinical trials in the 1940s". BMJ (Clinical Research Ed.) 319 (7209): 572–3. PMID 10463905. 
7. ^ Zhu M, Burman WJ, Jaresko GS, et al. (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. 

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 
• 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.

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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 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) 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

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