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AMINOGLYCOSI
DES
Streptomycin acts as a triacidic base through the effect of its two strongly basic guanidino
groups and the more weakly basic methylamino group. As a chemotherapeutic agent,
streptomycin is active against numerous Gram-negative and Gram-positive bacteria.
One of the greatest virtues of streptomycin is its effectiveness against the tubercle bacillus,
M. tuberculosis. By itself, the antibiotic is not a cure, but it is a valuable adjunct
to other treatment modalities for TB.
The possible development of damage to the otic nerve by the continued use of
streptomycin containing preparations has discouraged the use of such products. There has
been an increasing tendency to reserve streptomycin products for the treatment of TB.
It remains one of the agents of choice, however, for the treatment of certain “occupational”
bacterial infections, such as brucellosis, tularemia, bubonic plague, and glanders.
Because streptomycin is not absorbed when given orally or destroyed significantly in the
GI tract, at one time it was used rather widely in the treatment of infections of the intestinal
tract.
For systemic action, streptomycin usually is given by intramuscular injection
It has a broad spectrum of activity against many common pathogens, both Gram-positive
and Gram negative. Gentamicin is effective in the treatment of various skin infections for
which a topical cream or ointment may be used. .
Resistant bacterial strains that inactivate gentamicin by adenylylation and acetylation,
however, appear to be emerging with increasing frequency.