c. Cautions and Warnings.
(1) This drug should be used cautiously in pregnant women because of the
fact that it can cross the placenta and cause ototoxicity (see d (1) below) in the fetus.
(2) Baseline audiometric tests should be run initially prior to therapy and
then frequently during therapy to guard against ototoxicity.
d. Adverse Reactions.
(1) Ototoxicity. Ototoxicity is toxicity to the eighth nerve possibly resulting in
damage to hearing and the sense of balance. Initial signs may include vestibular
damage causing nausea, vomiting, and vertigo. Other symptoms include tinnitis, roaring
noises, or a sense of fullness in the ears. Hearing loss, often permanent, may develop.
The frequency and severity of ototoxicity are proportionate to the age of the client, the
dosage level, and the duration of administration.
(2) Other Reactions. Other common adverse reactions include parathesia
(abnormal sensation) of the face, rash, fever, urticaria, angio-neurotic edema, and
eosinophilia. Allergic reactions occur most frequently with prolonged contact, either in
clients with a long course of therapy or in medical personnel administering the drug;
personnel preparing streptomycin solutions should wear gloves.
Superinfection. Superinfection may occur.
e. Supply. Streptomycin sulfate is supplied in 1-gram quantities of powder,
which must be reconstituted before injection. Streptomycin sulfate injection, 0.4
gram/ml, is supplied in 2.5-ml cartridge-needle units.
KANAMYCIN SULFATE INJECTION
a. Indications. Kanamycin (Kantrex) is a broad-spectrum bactericidal antibiotic.
Because of its potential for toxic side effects, its use is limited mainly to certain serious
gram-negative infections. It should not be used when less toxic anti-infective agents are
available. It is effective in the treatment of E. coli, Proteus species, Enterobacter
aerogenes, Klebsiella pneumoniae, Serratia marcescens, and Mima-Herrelea. Although
kanamycin is not the drug of choice for staphylococcal infections, it may be indicated
under certain conditions for the treatment of known or suspected staphylococcal
disease. These situations include:
(1) The initial therapy of severe infections where the organism is thought to
be either a gram-negative bacterium or a staphylococcus.
(2) Infections due to susceptible strains of staphylococci in clients allergic to
other less toxic antibiotics.