Streptomycin sulfate is an aminoglycoside antibiotic drug. Streptomycin sulfate has a strong antibacterial effect on Mycobacterium tuberculosis, and is not strong against most Gram-positive cocci (such as various Streptococcus) and bacilli (such as Pseudomonas aeruginosa, anaerobic bacteria), for many Gram The negative bacillus has a strong antibacterial effect. This product is effective against various skin tuberculosis, and has the effect of inhibiting the growth of Mycobacterium tuberculosis and the production of toxins. It has a bactericidal effect at high concentrations (>0.4 μg/mL). Mycobacterium tuberculosis is rapidly resistant to streptomycin and should be used in combination with other anti-tuberculosis drugs.
Drug use
For the treatment of infective endocarditis, plague and rabbit fever, influenza bacilli and Gram-negative bacilli infection caused by tuberculosis, Brinell and non-hemolytic streptococcus.
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Streptomycin sulfate is an aminoglycoside antibiotic. Streptomycin mainly binds to the bacterial ribosome 30S subunit and inhibits the synthesis of bacterial proteins. The bacteria are highly susceptible to drug resistance after contact with streptomycin. The combination of streptomycin and other antibacterial or anti-tuberculosis drugs can reduce or delay the development of drug resistance. For the treatment of rabbit fever, plague, severe brucellosis and nasal discharge (usually combined with tetracycline or chloramphenicol). It is also used for second-line treatment of tuberculosis, and is often used in combination with other anti-tuberculosis drugs.
Adverse reactions
Streptomycin sulfate has less damage to the kidneys, which is characterized by proteinuria and tubular urine, and some of the renal function is temporarily reduced. It can be recovered after stopping the drug. Severe permanent kidney damage is rare.
Precautions
Pregnancy D class. Pregnant and lactating women are banned. Disabled in patients who are allergic to streptomycin or other aminoglycosides. Renal dysfunction should be adjusted in time. Cranial nerve damage, myasthenia gravis, tremor paralysis and other patients with caution. 1. Cross-allergy Patients who are allergic to an aminoglycoside may also be allergic to other aminoglycosides.
2. Streptomycin should be used with caution in the following cases: (1) Loss of water can increase the concentration of blood and cause toxic reactions. (2) The eighth pair of cranial nerve damage, which can cause damage to the vestibular nerve and auditory nerve. (3) Myasthenia gravis or Parkinson's disease. (4) Renal function damage, because the product has nephrotoxicity.
3. The following examinations should be performed regularly during the course of treatment: (1) urine routine and renal function tests to prevent severe renal toxicity. (2) Hearing test or electrogram (especially high frequency hearing) measurement.
4. The blood concentration should be monitored when conditions are met, and the dose adjusted accordingly, especially for neonates, elderly, and patients with impaired renal function. The drug concentration should be maintained at 15~30mg/ml and the concentration of 5~10mg/ml in the 7.5mg/kg every 12 hours. The blood concentration should be maintained at the peak of 15mg/kg once a day. 56~64mg/ml, valley concentration <1mg/ml.
5. Interference with diagnosis: This product can increase the measured values of alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum bilirubin concentration and lactate dehydrogenase concentration; blood calcium The measured values of magnesium, potassium and sodium concentrations may be reduced. [Pregnant women and lactating women] This product is a class D for pregnant women, which is harmful to humans, but the benefits may be greater than the disadvantages. The product can pass through the placenta into the fetal tissue. It has been reported that pregnant women have caused fetal hearing damage after applying this product. Therefore, pregnant women must fully weigh the pros and cons before using the product. Breastfeeding women should stop breastfeeding during medication. [Children's medicine] This product belongs to aminoglycosides and should be used with caution in pediatrics. In particular, the kidney tissues of premature infants and newborns are not fully developed, which makes the half-life of this class of drugs prolonged, and the drug is easy to accumulate in the body and produce toxic reactions. [Geriatric patients] Older patients are prone to various toxic reactions after applying aminoglycosides, and blood levels should be monitored as much as possible during the course of treatment. Renal function in elderly patients has a certain degree of physiological decline, even if the renal function measurement value is within the normal range, a smaller therapeutic amount should be used.
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