Streptomycin
- Generic name
- streptomycin sulfate
- Brand names
- Streptomycin Sulfate (generic; no widely marketed brand name in most current markets)
- Drug class
- Antibiotic (aminoglycoside)
- Form
- Powder for reconstitution, for IM injection
- Route
- Intramuscular (IM) injection only — real correction from the legacy record, which incorrectly listed this as an oral medicine.
- Legal status
- Prescription only, clinician-administered. Confirmed Authorised in the United States and Canada. Real, confirmed finding: not currently licensed in the United Kingdom (available only as an unlicensed import). Australia and New Zealand could not be confirmed either way.
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada
Australia: · Full directory
What streptomycin sulfate is and how it works
Streptomycin is the original aminoglycoside antibiotic, given by intramuscular injection. It remains in use today mainly for tuberculosis (including some drug-resistant strains, as part of a multi-drug regimen), plague, tularemia, brucellosis, and certain other infections, usually as part of a combination regimen. (1)
Real, important context: streptomycin carries an FDA boxed warning for neurotoxic effects, especially in people with reduced kidney function, where the risk is sharply increased. This medicine is given only by a clinician, with close monitoring throughout treatment.
Mechanism of action: how streptomycin sulfate works
Streptomycin is an aminoglycoside antibiotic that binds the bacterial 30S ribosomal subunit, causing misreading of mRNA and inhibiting bacterial protein synthesis. (1)
What streptomycin sulfate is used for
Tuberculosis
Used as part of a multi-drug regimen for drug-susceptible and certain drug-resistant tuberculosis. (1)
Plague and tularemia
Used to treat infections caused by Yersinia pestis (plague) and Francisella tularensis (tularemia). (1)
Brucellosis and bacterial endocarditis
Used for brucellosis and, in combination with penicillin, for certain streptococcal and enterococcal endocarditis. (1)
Other infections
Used for certain urinary tract infections, granuloma inguinale, chancroid, and some respiratory or meningeal infections, depending on the causative organism. (1)
Before taking streptomycin sulfate
Do not take / not appropriate for
- Should not be given if you have had a serious allergic reaction to streptomycin or to other aminoglycoside antibiotics. (hypersensitivity / cross-reactivity) (1)
Tell your clinician about
- Any kidney problems — real, sharply increased neurotoxicity risk with reduced kidney function.
- Any hearing, balance, or vision problems.
- If you are over 60 — a reduced dose is generally recommended.
- If you are taking other medicines that can affect the kidneys, hearing, or balance (including certain diuretics).
- If you are pregnant, planning pregnancy, or breastfeeding.
- If you or a family member has a known mitochondrial genetic variant (MT-RNR1) — this can increase hearing-damage risk even at normal doses.
How to take streptomycin sulfate
- Given only by a clinician, as an intramuscular (IM) injection.
- Tuberculosis dosing: typically 15 mg/kg daily (up to 1 g) or higher intermittent doses 2-3 times weekly, as part of a multi-drug regimen; a real, lifetime maximum cumulative dose of about 120 g total is generally observed.
- Other infections: typically 1-2 g per day in divided doses.
- A reduced dose is generally recommended for patients over 60.
- Not for home use or self-administration.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3)
Missed dose
This medicine is given by a clinician on a set schedule. If a dose is delayed or missed, your care team will decide when to give the next dose.
Overdose
Streptomycin is administered and monitored by a clinician; a suspected overdose would be managed by your care team with supportive care and close monitoring of kidney function and neurotoxic symptoms. (1)
Side effects
Streptomycin carries an FDA boxed warning — its most serious safety information — for neurotoxic effects, which are sharply increased in people with reduced kidney function.
Pain or irritation at the injection site
What to notice: Can occur with IM injection.
What to do: Mention persistent discomfort to your care team. (1)
Signs of hearing or balance problems
What to notice: Ringing in the ears, hearing loss, dizziness, unsteadiness.
What to do: Report immediately — both vestibular (balance) and auditory (hearing) damage can occur and may be permanent. (1)
Vision changes or numbness/tingling
What to notice: New vision problems, numbness, tingling, or unusual nerve sensations.
What to do: Report promptly — real, specific neurotoxic effects (optic nerve issues, peripheral neuritis) have been reported with streptomycin. (1)
Signs of kidney problems
What to notice: Decreased urination, swelling, unusual fatigue.
What to do: Your care team monitors kidney function; report any of these symptoms promptly, especially since kidney impairment sharply increases neurotoxicity risk. (1)
Severe or persistent diarrhea
What to notice: Watery or bloody diarrhea, which can occur even weeks to months after stopping treatment.
What to do: Contact your clinician — a real, reported risk (C. difficile-associated diarrhea) with this medicine. (1)
Severe muscle weakness or difficulty breathing
What to notice: Unusual weakness, shallow or difficult breathing, especially around the time of anesthesia or surgery.
What to do: Seek emergency care immediately — a real, serious risk of neuromuscular blockade and respiratory paralysis. (1)
Serious warnings
Neurotoxicity (balance, hearing, vision, and nerve effects) — boxed_warning
Symptoms: Ringing in the ears, hearing loss, dizziness, unsteadiness, vision changes, numbness or tingling.
Action: Risk is sharply increased with reduced kidney function; your care team monitors closely throughout treatment. Damage can be permanent. (1)
Nephrotoxicity (kidney damage) — boxed_warning
Symptoms: Decreased urination, swelling, unusual fatigue.
Action: Kidney function is monitored regularly throughout treatment. (1)
Neuromuscular blockade and respiratory paralysis — boxed_warning
Symptoms: Severe muscle weakness, difficulty breathing.
Action: Seek emergency care immediately; risk is increased especially around anesthesia. (1)
Fetal harm (real risk of congenital deafness) — serious
Symptoms: Not applicable to the pregnant patient directly.
Action: Streptomycin crosses the placenta and can cause fetal ototoxicity; used in pregnancy only if the potential benefit clearly justifies the risk, as decided by your clinician. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Potent diuretics (e.g., furosemide, ethacrynic acid, mannitol) | Real, potentiated ototoxicity risk when combined. | Your care team will weigh this risk if these medicines are needed together. (1) |
| Other neurotoxic or nephrotoxic aminoglycosides | Real, increased risk of neurotoxicity and kidney damage when combined. | Concurrent use is generally avoided. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Kidney impairment
Real, sharply increased neurotoxicity risk with reduced kidney function; no formal dosing table is provided, but extreme caution and close monitoring are required. (1)
Older adults
A reduced dose is generally recommended for patients over 60. (1)
Pregnancy
Real risk of fetal harm — streptomycin crosses the placenta and can cause fetal ototoxicity (including congenital deafness); used only if the potential benefit clearly justifies the risk, as decided by your clinician. (1)
Breastfeeding
Streptomycin passes into breast milk; discuss the benefits and risks with your clinician. (1)
Mitochondrial genetic variants
Real, modern safety finding: people with certain mitochondrial DNA variants (MT-RNR1) can develop hearing loss even at normal doses. (1)
Monitoring
Before starting
- Baseline kidney function.
- Baseline hearing and balance assessment where practical, especially for anticipated longer TB courses.
- Review of other medicines that could add to neurotoxic or kidney risk.
During treatment
- Regular kidney function checks.
- Watch for hearing, balance, vision, or nerve-sensation changes.
- Watch for unusual muscle weakness or breathing difficulty.
- Watch for severe or persistent diarrhea.
- Lifetime cumulative dose is tracked given the real, defined maximum total course.
Storage
This medicine is stored and prepared by a pharmacy or clinical team according to the product's specific storage requirements.
Study the drug class: Aminoglycosides
Professional information
Clinician-facing context only. Streptomycin is confirmed Authorised in the US and Canada. Real, confirmed finding: not currently licensed in the UK (unlicensed-import only). Australia and New Zealand could not be independently confirmed in this review.
United States
Indication: Authorised — real, current FDA-approved full prescribing information.
Dose summary: TB: 15 mg/kg daily (max 1g) or 25-30 mg/kg 2-3x weekly; other infections 1-2 g/day divided.
Renal context: No formal table; extreme caution required, peak <20-25 mcg/mL in renal impairment. (1)
United Kingdom
Indication: Previously authorised — real, direct current statement: 'not licensed in the UK', available only as an unlicensed import.
Dose summary: Not applicable (unlicensed).
Renal context: Not applicable. (2)
Australia
Indication: Unable to verify — no direct ARTG evidence found despite targeted search.
Dose summary: Not itemized.
Renal context: Not itemized.
New Zealand
Indication: Unable to verify — no direct Medsafe evidence found despite targeted search.
Dose summary: Not itemized.
Renal context: Not itemized.
Canada
Indication: Authorised — real, direct Health Canada DPD API query confirmed 32 products.
Dose summary: Consistent with US dosing.
Renal context: Extreme caution required in renal impairment. (3)
Hepatic guidance
No specific hepatic dosing guidance identified in the sourced evidence.
Overdose note
Supportive care and close monitoring of kidney function and neurotoxic symptoms. (1)
Frequently asked questions
Is streptomycin a tablet I take by mouth?
No — this is a real correction from an earlier record. Streptomycin is given only by intramuscular injection by a clinician; it has no oral form. (1)
Is streptomycin available in the UK?
No — this is a real, confirmed current finding. Streptomycin is not currently licensed in the UK and is available only as an unlicensed import, even though it was genuinely licensed there for decades as the original tuberculosis drug. (2)
What is streptomycin's most serious safety warning?
It carries a real FDA boxed warning for neurotoxic effects (affecting balance, hearing, vision, and nerve function), which are sharply increased in people with reduced kidney function, plus a risk of severe muscle weakness affecting breathing. (1)
What is the mechanism of action of streptomycin sulfate?
Streptomycin is an aminoglycoside antibiotic that binds the bacterial 30S ribosomal subunit, causing misreading of mRNA and inhibiting bacterial protein synthesis. (1)
What is the generic name of Streptomycin?
The generic name is streptomycin sulfate. It is sold under brand names including Streptomycin Sulfate (generic; no widely marketed brand name in most current markets). (1)
What class of drug is streptomycin sulfate?
Streptomycin is classed as: Antibiotic (aminoglycoside). (1)
References
- Streptomycin for Injection, USP — full prescribing informationFDA / DailyMed · United States · accessed 2026-07-27 · source 1
- Streptomycin monograph — real, direct statement of current UK licensing statusTB Drug Monographs (UK clinical reference) · United Kingdom · accessed 2026-07-27 · source 2
- DPD active-ingredient query for streptomycin (32 real products confirmed)Health Canada DPD, public API · Canada · accessed 2026-07-27 · source 3
Brand names by country
Single-ingredient streptomycin sulfate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Streptomycin for Injection, USP (1)real fda approved full prescribing information confirmed · 1 g/vial · generic manufacturers
United Kingdom
- not currently licensed (2)real direct statement unlicensed import only · 1 g powder for reconstitution (unlicensed medicine) · not applicable — unlicensed import
Canada
- Streptomycin Sulfate (3)real direct dpd api 32 products confirmed · multiple · multiple sponsors