Streptomycin (Intramuscular)

Streptomycin is listed as an essential antibiotic for the treatment of a broad spectrum of bacterial infections, including tuberculosis and meningitis.


Streptomycin is a type of antibiotic used to treat a host of bacterial infections in targeted locations throughout the body. It is generally administered for severe infections that are unresponsive to conventional treatments.

Even though Streptomycin is widely considered to be a potent antibiotic, taking this medicine comes with serious risks. In particular, medical researchers have noted adverse contraindications in newborn infants and geriatric patients, who are more susceptible to the risk of hearing loss and neurotoxicity.

The drug is available by prescription only and may be ordered for at-home or in-hospital use - depending on the length of treatment needed.

The most common conditions that are treated include:

  • Pasteurella Pestis (Plague)
  • Francisella Tularensis (Tularemia)
  • Brucella
  • H. Ducreyi (Chancroid)
  • H. Influenzae
  • Meningeal Infections
  • Pneumonia
  • E.Coli
  • Urinary Tract Infections
  • Streptococcus Viridans
  • Tuberculosis
  • Mycobacterium Avium Complex
  • Endocarditis
  • Brucellosis
  • Burkholderia Infection
  • Tularemia
  • Rat Bite Fever

Streptomycin has been consistently included in the List of Essential Medicines - an annual publication by The World Health Organization. Patients should note that this and any other antibiotic is not an effective treatment for viral infections like the cold or flu.

The drug is often publicized as the first antibiotic cure for tuberculosis. In such medical cases, Streptomycin is prescribed concomitantly with other anti-tuberculosis agents for the maximum effectiveness.

Condition(s) treated?

  • Tuberculosis, Plague
  • Tularemia
  • Brucella, E. Coli
  • Influenza
  • Pneumonia
  • Strep
  • Meningitis
  • UTIs

Type of medicine?

  • Aminoglycoside Antibiotics, Protein Synthesis Inhibitor

Side Effects

Streptomyicn could lead to mild to severe side effects. Explore some of the potential risks of taking this medication below:

The most common side effects of Streptomycin intramuscular injections Include:

  • A Tingling Sensation
  • Bleeding
  • Bruised Skin
  • Chest Tightness or Pain
  • Feeling Constant Motions
  • Feeling Nauseas
  • Feeling Off Balance
  • Feeling Sleepy
  • Fever or Chills
  • Hives and Rashes
  • Stools That Are Black
  • Swelling in Different Areas of the Body
  • Swollen Eyelids
  • Trouble Breathing
  • Trouble Urinating

The less common side effects of Streptomycin intramuscular injections include:

  • Appetite Changes
  • Blurred Vision Or Vision Loss
  • Feeling Dehydrated
  • Hearing Loss
  • Irregular Heartbeat
  • Lower Backache
  • Migraines
  • Sensitive Teeth and Gums
  • Stomach Cramps
  • Trouble Swallowing Or Breathing
  • Urine Color Changes
  • Wheezing Or Tightness in the Chest
  • Yellow Skin Or Eyes

The rare side effects of Streptomycin intramuscular injections include:

  • Decreased Urine Output
  • Edema
  • Feeling Dehydrated
  • Lethargy
  • Muscle Weakness

When to call a doctor

Some of the aforementioned side effects subside with time. However, alarming symptoms such as an allergic reaction, wheezing, hearing loss, or trouble breathing are serious. In these events, 911 should be contacted immediately.

Bacterial resistance

Streptomycin antibiotics may also lead to a superinfection, meaning the underlying bacteria does not respond to treatment. Due to this risk of bacterial resistance, medical providers only prescribe Streptomycin for bacterial strains that have a demonstrated susceptibility to the drug. In the event of a superinfection, another course of treatment is usually administered.

Hearing loss

One of the most common but nonetheless serious concerns of prescribing Streptomycin is the risk of hearing loss, which may be permanent or transient. Medical studies have concluded that Streptomycin could impact the cranial nerve, and hence lead to:

The amount of damage that occurs is directly related to factors such as:

  • The Age of the Patient (Infants are More Susceptible to Permanent Hearing Loss)
  • The Amount of Dosage Given to Patients
  • The Length of Treatment
  • Underlying Medical Conditions


The average dose for Streptomycin varies from one patient to another and is largely dependent on the underlying condition, as well as the patient's age, weight, and other factors.

The following outlines provide a general idea of the standard dose of Streptomycin, based on the condition it is used to treat.

Do not use this guide as a replacement for what your doctor has prescribed. Patients should never stop or alter doses unless directed by a primary health provider:

Dosage amounts for Tuberculosis


  • Daily Dose: 15 mg | Max Dose (1 g)
  • Bi-Weekly Dose: 25-30 mg | Max Dose (1.5 g)
  • Tri-Weekly Dose: 25-30 mg | Max Dose (1.5 g)


  • Daily Dose: 20-40 mg | Max Dose (1 g)
  • Bi-Weekly Dose: 25-30 mg | Max Dose (1.5 g)
  • Tri-Weekly Dose: 25-30 mg | Max Dose (1.5 g)

Note: Streptomycin is commonly used as a part of the treatment for tuberculosis. Other anti-tuberculosis agents are generally provided concomitantly with this medicine for maximum effectiveness.

Dosage amounts for Tularemia

1-2 g | Divided Daily | 7-14 Days

Dosage amounts for Plague

2 g | 2X Daily | 10 Days

Dosage as a second-line treatment

For other bacterial infections such as pneumonia, meningitis, brucellosis, or UTIs, for instance, the following doses are suggested:

  • Adults: 1-2 g | Divided Daily | 6-12 Hour Intervals | Max Dose (2g)
  • Children: : 20-40 mg | Divided Daily | 6-12 Hour Intervals (Reduced Dose Recommended)

Streptomycin intramuscular injections are administered on a planned schedule to ensure maximum effectiveness.

Missed dose

If you have been prescribed in-home shots and forget to take a dose, take it as soon as you remember, but do not double up. If the time for the next dose is drawing near, skip the missed dose and contact a medical provider or pharmacist for help.

How to administer

For the most part, Streptomycin is always injected into the muscles. However, in other parts of the world outside the United States, some institutions complete intravenous applications of Streptomycin.

To administer Streptomycin, a trained medical worker generally inserts the prescribed amount into a large muscle area. For in-home shots, clear and detailed instructions are typically provided by a pharmacist.

To avoid damage to the peripheral nerves, care should be taken when administering the injection. The standard recommendation is to inject the approved amount into a large muscle, such as the:

  • Buttocks
  • Outer Thighs
  • Upper Arms

Medical workers will continue treatments even if the patient responds well and shows signs of good health to ensure that the bacterial infection/s it is used to treat has cleared up completely.

Precautions for administering Streptomycin

Follow these best practices for administering Streptomycin:

  • Exercising safety - Medical workers should always wear gloves and protective gear, in addition to using sterile needles for each dose. All needles are for one-time use only and should be disposed of following use in a biohazard waste container.
  • Prolonged treatment - To reduce pain and the risk of secondary infections in patients who have been prescribed longer doses of Streptomycin, the injection site should be alternated.
  • Water intake - As a general rule of thumb, patients are given copious amounts of water to drink to prevent the development or worsening of kidney issues. Patients can expect to pass a lot of urine as a result. In some cases, a catheter may be necessary until patients recover fully and are able to use the bathroom independently.


Certain medications are not recommended for simultaneous use with Streptomycin intramuscular injections. These include but aren't limited to:

  • Alcuronium
  • Ataluren
  • Atracurium
  • Bumetanide
  • Cholera Vaccine, Live
  • Cidofovir
  • Cisatracurium
  • Colistimethate Sodium
  • Decamethonium
  • Doxacurium
  • Ethacrynic Acid
  • Fazadinium
  • Foscarnet
  • Furosemide
  • Gallamine
  • Hexafluorenium
  • Lysine
  • Metocurine
  • Mivacurium
  • Pancuronium
  • Pipecuronium
  • Rapacuronium
  • Rocuronium
  • Succinylcholine
  • Tubocurarine
  • Vecuronium

The most notable contraindications are with the following classes of drugs:

  • Diuretics
  • Ethacrynic Acid
  • Furosemide
  • Mannitol

Lifestyle habits

Discuss with your doctor if you regularly drink or smoke, as these lifestyle habits could influence how the medication works and may possibly cause negative interactions to occur. Also advise your doctor of any notable food intake that could potentially trigger an allergic reaction.

Pre-existing medical conditions

Certain underlying medical conditions may get worse with the use of Streptomycin intramuscular injections. These include:

Due to these risks, it's important for patients to disclose their full medical history. Doctors may adjust dosage or use an alternative treatment to Streptomycin intramuscular injections in some cases.


As with all medicines, patients and providers should use caution when administering Streptomycin intramuscular injections. Learn the warning signs after use and the precautions that must be placed into consideration before treatment.

Risk of allergies

This medicine could cause a serious allergic reaction to occur. Be sure to tell your doctor if you've had a history of allergies to any medications as well as any hypersensitivity to foods, dyes, preservatives, or animal by-products. Some warning signs of an allergic reaction to Streptomycin intramuscular injections include:

  • Feeling Itchy All Over
  • Hives
  • Hoarseness
  • Labored Breathing or Difficulty Swallowing
  • Sudden Swelling of the Upper Body Area

If any of these symptoms occur, tell your doctor and call 911 right away.


As mentioned earlier in this article, the use of Streptomycin in newborns could negatively affect auditory and mobility functions. Most notably, Streptomycin could cause permanent hearing loss.

Another risk that is noted in this demographic is CNS depression. Medical specialists advise prescribing the lowest dose of the medicine for infants as a result.


The use of Streptomycin by seniors could lead to the development or worsening of kidney problems. Medical providers should therefore review patients' full medical history to assess the risks and moreover adjust the dosage, if applicable.

Expecting mothers

Studies have uncovered that prescribing Streptomycin to expecting mothers could pose serious risk to the fetus. Nevertheless, this treatment may still be necessary in a life or death situation - where both the mother's and baby's lives are at risk.

Women who are not pregnant should take birth control as an extra precaution to prevent pregnancy - and until a doctor advises that it is safe to get pregnant.

Hearing and sensory issues

Patients should take a note of the risks associated with Streptomycin intramuscular injections and advise a medical provider right away if any of the following issues arise following use:

  • A Constant Sense of Movement
  • Feeling Dizzy or Faint
  • Hearing Loss (Mild or Severe)
  • Ringing Ears

Hospital tests after use

Patients who have been given Streptomycin intramuscular injections in a hospital setting undergo a series of tests.

These assessments are done to determine if any serious side effects have resulted from the use of Streptomycin. The most standard tests that are completed include:

  • Blood and Urine Tests
  • Hearing Tests
  • Nervous System Checks

Follow-up visits

At times, the only way to determine if a serious bacterial infection is fully cleared is the lapse of time.

For certain bacterial infections, such as syphilis, for example, supplementary visits are scheduled roughly 12 weeks following treatment. During these follow-ups, patients can expect lab work to be performed once more, including blood and urine tests to trace any leftover signs of the disease.


If you have a pre-planned surgery scheduled in the near future, inform your doctor of any recent Streptomycin treatments. Using this medicine together with numbing medicines could cause adverse and potentially serious side effects.


Streptomycin vials should be stored at room temperature and away from heat or direct sunlight.

Keep this medication out of the reach of children and pets in a locked container.


Streptomycin intramuscular injections are prescribed for stopping the spread of bacteria and inhibiting future growth. As with most antibiotics, however, Streptomycin is not used to treat viral infections, such as the cold or flu.

It is, however, used as the first line of treatment against serious bacterial infections, such as tuberculosis, plague, pneumonia, and some strains of strep.

Patients should continue treatments with Streptomycin for the prescribed length of time, even if they feel better. This helps improve the chances of clearing the underlying infection completely.

Periodic urine, blood, and hearing tests are moreover recommended at follow-up visits to determine if the underlying disease is fully cured.

Streptomycin should be used with caution in expecting mothers as the medicine crosses the placental barrier and could possibly cause permanent hearing loss in the fetus.

Doctors are advised to only prescribe Streptomycin for bacterial strains that have a proven history of being responsive to this treatment.

Last Reviewed:
December 22, 2017
Last Updated:
April 05, 2018