Pronunciation: strep-toe-MY-sin Sull-fate
Class: Aminoglycoside, parenteral, Antituberculosis agent
- Injection 400 mg/mL
- Lyophilized cake/Powder for injection 200 mg/mL
Interferes with protein synthesis.
Peak serum levels are reached within 1 hr following IM injection.
Appreciable concentrations are found in all organ tissue except the brain.
Following a single 600 mg dose, 29% to 89% is excreted in the urine within 24 hr.
Indications and Usage
Treatment of moderate to severe infections caused by susceptible strains of Mycobacterium tuberculosis and nontuberculosis infections.
Hypersensitivity to aminoglycosides or any component of the product.
Dosage and AdministrationTuberculosis
IM 15 mg/kg/day (max, 1 g) or 25 to 30 mg/kg 2 or 3 times weekly (max, 1.5 g).Children
IM 20 to 40 mg/kg/day (max, 1 g) or 25 to 30 mg/kg 2 or 3 times weekly (max, 1.5 g).Tularemia
IM 1 to 2 g/day in divided doses for 7 to 14 days until patient is afebrile for 5 to 7 days.Plague
IM 2 g/day in 2 divided doses for minimum of 10 days.Bacterial Endocarditis
IM 1 g twice daily for 1 wk then 0.5 g twice daily for the second week in combination with penicillin. In patients older than 60 yr of age, give 0.5 g twice daily for the entire 2 wk period.Enterococcal
IM 1 g twice daily for 2 wk and 0.5 g twice daily for 4 wk in combination with penicillin.Concomitant Use with Other Agents
IM 1 to 2 g in divided doses every 6 to 12 hr for moderate to severe infections (max, 2 g/day).Children
IM 20 to 40 mg/kg/day in divided doses every 6 to 12 hr, avoiding excessive doses.
Store injection in refrigerator (36° to 46°F). Store cake/powder for injection at controlled room temperature (59° to 86°F). Reconstituted solution may be stored for up to 1 wk at controlled room temperature (59° to 86°F). Protect reconstituted solution from light.
Drug InteractionsEthacrynic acid, furosemide, mannitol, possibly other diuretics
May potentiate the ototoxic effects of streptomycin.Neurotoxic or nephrotoxic agents (eg, colistin, cyclosporine, gentamicin, kanamycin, neomycin, paromomycin, polymyxin B, tobramycin)
May increase the risk of neuro- or nephrotoxicity and should be avoided.
Laboratory Test Interactions
None well documented.
Rash; urticaria; exfoliative dermatitis.
Vestibular ototoxicity (eg, nausea, vomiting, vertigo); cochlear ototoxicity (deafness); amblyopia.
Eosinophilia; leukopenia; thrombocytopenia; pancytopenia; hemolytic anemia.
Paresthesia of face; fever; angioneurotic edema; anaphylaxis; muscular weakness.
Risk of severe neurotoxic reactions (including cochlear and vestibular dysfunction, optic nerve dysfunction, peripheral neuritis, arachnoiditis, and encephalopathy) increase in patients with impaired renal function or pre-renal azotemia.Nephrotoxicity
Avoid concurrent use of nephrotoxic/neurotoxic drugs.
Monitor renal function carefully. Patients with reduced function should have reduced doses. Peak serum concentrations in patients with renal dysfunction should be 20 to 25 mcg/mL or less.
Category D . Crosses the placenta and may cause fetal harm.
Excreted in breast milk.
See Route/Dosage section.
Because of increased risk of side effects, reduce the dose in patients older than 60 yr of age.
May result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Reduced doses are necessary.
- Advise patient that medication will be prepared and administered by a health care provider in a health care setting.
- Review dosing schedule and prescribed length of therapy with patient.
- Instruct patient to immediately report the following to health care provider: headache, nausea, vomiting, ringing in the ears, vertigo (feeling of whirling motion), dizziness, roaring noises, sense of fullness in ears, hearing loss, itching, rash.
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