Streptomycin side effects

The introduction of streptomycin as an antibiotic in 1944 was welcomed as the long-sought solution to combat tuberculosis and other intractable gram-negative infections. The first clinical trial, however, already highlighted the side effects... 

Thiacetazone is active against many strains of M. tuberculosis. It is not marketed in the United States. However, because of its low cost, it is used as a first-line agent in East Africa, especially in combination with compounds such as isoniazid. The most common side effects of thiacetazone include GI intolerance and development of rashes. It causes significant ototoxicity, especially when coadministered with streptomycin. Life-threatening hypersensitivity reactions, such as hepatitis, transient marrow aplastic syndromes, neutropenia, and thrombocytopenia, have been reported. 

The selection of transformed chloroplasts usually involves the use of an antibiotic resistance marker. Spectinomycin is used most routinely because of the high specificity it displays as a prokaryotic translational inhibitor as well as the relatively low side effects it exerts on plants. The bacterial aminoglycoside 3 -adenyltransferase gene (ciadA) confers resistance to both streptomycin and spectinomycin. The aadA protein catalyzes the covalent transfer of an adenosine monophosphate (AMP) residue from adenosine triphosphate (ATP) to spectinomycin, thereby converting the antibiotic into an inactive form that no longer inhibits protein synthesis for prokaryotic 70S ribosomes that are present in the chloroplast. 

Ethambutol suppresses the growth of isoniazid- and streptomycin-resistant tubercle bacilli. The most important but not common side effects are optic neuritis, decreased visual acuity, and inability to perceive the color green. 

Streptomycin is ototoxic and nephrotoxic. Vertigo and hearing loss are the most common side effects and may be permanent. Toxicity is dose-related, and the risk is increased in the elderly. As with all aminoglycosides, the dose must be adjusted according to renal function (see Chapter 45 Aminoglycosides Spectinomycin). Toxicity can be reduced by limiting therapy to no more than 6 months whenever possible. 

Rifampicin can cause renal failure, transient disturbances of liver function tests, hyperbilirubinaemia or severe hepatotoxicity and other side-effects. Streptomycin can cause renal and ototoxicity. The combination of rifampicin and streptomycin increases the risk of streptomycin-induced renal failure. 

PLATINUM COMPOUNDS AMINOGLYCOSIDES, CAPREOMYCIN, COLISTIN, STREPTOMYCIN, VANCOMYCIN t risk of renal toxicity and renal failure and of ototoxicity. The ototoxicity tends to occur when cisplatin is administered early during the course of aminoglycoside therapy Additive renal toxicity Monitor renal function prior to and during therapy, and ensure an intake of at least 2 L of fluid daily. Monitor serum potassium and magnesium and correct any deficiencies. Most side-effects of aminoglycosides are dose-related, and it is necessary to t interval between doses and 1 dose of aminoglycoside if there is impaired renal function... 

D. Treatment of bacterial infections Antibiotics that selectively affect bacterial function and have minimal side effects in humans are usually selected to treat bacterial infections. Rifampicin, which inhibits the initiation of prokaryotic RNA synthesis, is used to treat tuberculosis. Streptomycin, tetracycline, chloramphenicol, and erythromycin inhibit protein synthesis on prokaiyotic ribosomes and are used for many infections. Chloramphenicol affects mitochondrial ribosomes and must be used with caution. 

In hypercalcemia, excessive volume depletion, hyponatremia, and hypotension are major risks associated with the use of loop diuretics, and the side effects of hypokalemia, hyperuricemia, and hyperglycemia are always present. Loop diuretics should not be used concurrently with ototoxic aminoglycoside antibiotics (i.e., streptomycin, gentamicin, kanamycin, tobramycin). 

Side effects of streptomycin and dihydrostreptomycin treatment are mainly toxic in nature. Toxicity to the auditory vestibular organs, nephrotoxicity, hepatotoxicity, and toxicity to the bone marrow have all been observed (Rasmussen 1972 Hoigne 1975). There are also reports of peripheral neuritis and neuromuscular blockade, occurring presumably as a result of the potentiation of non-depolarizing anesthetics (Hoigne 1975). Because of its strong ototoxicity, dihydrostreptomycin is no longer in use in the Western hemisphere. 

Rasmussen F (1972) Side effects of streptomycin sulphate. Scand J Respir Dis 53 35-37... 

Streptomycin can cause many side effects for the patient. These side effects include fever, rashes, ototoxicity, nephrotoxicity, and kidney malfunction (Syal et al., 2013). 

On the other hand, the antibiotic chloramphenicol binds to the bacterial ribosomes, but not the larger ribosomes of animals, thereby showing greater specificity. This inhibits peptide bond formation. Chloramphenicol is relatively nontoxic, but it still must be used with caution as side effects such as anemia can result. Other antibiotics which inhibit protein synthesis include the tetracyclines, streptomycin, and cycloheximkle. 

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