Streptomycin: Chemical Formula, Presentation, Indications, Mechanism of Action, Dosage, Interactions and Side Effects

It is a broad-spectrum bactericidal antibiotic. It is active against gram-positive and gram-negative bacteria.

Streptomycin is an inhibitor of several Mycobacterium species and is an effective antibiotic for treating tuberculosis caused by M. tuberculosis.

Chemical formula

  • C21H39N7O12.


  • Injectable powder in 1 g vials (in sulfate form).


Streptomycin is a broad-spectrum antibiotic used as the primary treatment for tuberculosis. This disease mainly affects the respiratory system and other infectious diseases that affect the brain, respiratory system, and internal tissues of the heart, especially the valves such as:


Streptomycin is used to treat active tuberculosis caused by Mycobacterium tuberculosis when other anti-tuberculosis drugs such as rifampin or isoniazid are ineffective or the type of tuberculosis cannot be treated with conventional therapy.


Streptomycin is used as the first-line treatment for tularemia, a severe infectious disease caused by Francisella tularensis, which causes fever, and ulceration and can cause swollen lymph nodes.

It can also cause severe pneumonia.

Endocarditis bacteriana

Streptomycin is used to treat endocarditis caused by streptococci and enterococci, which affects the internal tissues of the heart, the endocardium, and especially the heart valves.


Meningitis bacterial

This medicine is indicated to treat bacterial meningitis caused by group B Streptococcus or Neisseria species.

Bacterial meningitis is characterized by inflammation of the protective covering of the brain and spinal cord, fever, headache, stiff neck, vomiting, confusion, and an inability to tolerate loud noises or light.


Streptomycin is used to treat plague caused by the bacteria Yersinia pestis. The epidemic is characterized by the sudden onset of fever, headache, diarrhea, vomiting, and fatigue with muscle pain.


It is a disease that generally affects the genitals; it presents as a granuloma. This disease is caused by the Gram-negative bacillus Klebsiella granulomatis.


It is an infection caused by Haemophilus ducreyi. It is a sexually transmitted disease.

It is a soft chancre and manifests as a genital ulcer.

Mechanism of action

Like other aminoglycosidic antibiotics such as Gentamicin, Neomycin, Kanamycin, and Tobramycin, Streptomycin inhibits protein synthesis in bacterial cells by binding to the 30S subunit of ribosomes.

In doing so, streptomycin causes a structural change that interferes with the recognition site of the codon-anticodon interaction resulting in a misreading of the genetic message carried by the messenger RNA.


Streptomycin must be administered by deep intramuscular injection. Absorption from the injection site is rapid, and peak serum concentrations are reached within 1 to 2 hours.

The recommended dose of streptomycin is 15 mg per kg of body weight, in 12 to 18 mg per kg of body weight, with a maximum in adults of 1 g per day.

Side effects

Streptomycin is toxic and causes side effects such as allergic responses, hearing loss, nausea, and kidney damage.

Highly purified streptomycin is not toxic when administered in small doses. Still, it appears to have a cumulative detrimental effect on the nervous system when administered as a drug over long periods.

The most common side effects of streptomycin are:

  • Severe allergy.
  • Fever.
  • Burning or tingling sensation
  • Vertigo.
  • Nausea and vomiting
  • Difficult or painful urination
  • Blurred or double vision
  • Severe hearing impairment.
  • Rapid, irregular heartbeats.
  • Increased thirst.

Warnings and Contraindications

  • Interaction with alcohol is unknown. It is advisable to consult a doctor before consumption.
  • This medicine in pregnant women is not recommended unless necessary.
  • Before receiving this medication, all risks and benefits should be discussed with your doctor.
  • The use of this medicine is not recommended in breastfeeding women unless necessary. The baby should be closely monitored for side effects if this medicine is used.
  • This medicine is not recommended in patients with a known allergy to streptomycin or other aminoglycosides.
  • Streptomycin is not recommended in patients with hearing problems, as it can increase the risk of deafness.
  • Elimination of streptomycin is primarily renal, with 50-60% not excreted; renal function should be regularly assessed in patients receiving streptomycin and should be used with caution when renal function is not optimal.
  • Streptomycin is not recommended in patients with kidney failure as it may increase the risk of kidney damage.
  • The trouble is significantly more prominent when high doses of this drug are used for an extended period.
  • Appropriate dose adjustments should be made based on creatinine clearance.


Streptomycin has interactions and produces severe reactions with the concomitant use of the following medications:

  • Colistin.
  • Furosemide.
  • Neuromuscular blockers.
  • Antiretroviral drugs.