Introduction to streptomycin

Streptomycin, Mycobacterium tuberculosis have a strong inhibitory effect, in the treatment of tuberculosis has played an important role. In addition, it is susceptible to epidemic Mycobacterium tuberculosis, Escherichia coli, Shigella, Pseudomonas aeruginosa and Yersinia pestis. Streptomycin on the auditory nerve toxicity, long-term use caused by deafness, can also cause allergic reactions, such as rash, fever and even shock.

Streptomycin historical data

Streptomycin was invented in 1944. Its anti-Mycobacterium tuberculosis effect, creating a new era of TB treatment. Since then, Mycobacterium tuberculosis raging human life for thousands of years of history to contain hope. Streptomycin is an antibiotic that is extracted from the culture medium of Streptomyces lividans. Which belongs to the aminoglycoside basic compound and binds to the protein of tubercle bacillus bacterial ribosomal protein, and functions to interfere with the protein synthesis of Mycobacterium tuberculosis, thereby killing or inhibiting the growth of Mycobacterium tuberculosis. Streptomycin intramuscular injection of pain response is relatively small, suitable for clinical use, as long as the application of appropriate choice of objects, the dose and more appropriate, most patients can long-term injection (usually about 2 months). Therefore, the application of anti-TB treatment for decades it is still the main drug.

Streptomycin after intramuscular injection, the peak absorption of blood concentration can be in half an hour to two hours, the effective inhibition of bacterial growth can be maintained for 12 hours, older patients may be longer. Streptomycin excretion by the kidneys. After injection of streptomycin, it is easy to penetrate the chest, abdominal cavity, can also enter the fetus through the placenta amniotic fluid, and drug concentration is higher, because the higher concentration of amniotic fluid, it can not be used for pregnant women. And because they can not (or a small amount through) the blood-brain barrier, it can not be used for the treatment of tuberculous meningitis.

Streptomycin production

Streptomycin is a broad-spectrum antibiotic produced by Streptomyces griseus and consists of streptomycin, streptomycin and N-methyl-L-glucamine. Streptomycin Streptomyces albumin in the part of the aldehyde group was reduced to primary alcohol base, it becomes dihydrostreptomycin, its antibacterial efficacy and streptomycin is about the same, but the auditory nerve toxicity than streptomycin. Production process is divided into two steps: ① bacteria fermentation, the cold or dry tube of the Streptomyces spores were inoculated to the slope of the medium, cultured at 27 ℃ for 7 days. After the spores were covered with the spores, the suspension was transferred into shake flasks with culture medium and cultured at 27 ° C for 45 to 48 hours. After the growth of the hyphae was vigorous, several shaking flasks were taken, and the culture medium was combined Inoculated in a sterilized culture medium in a seed tank, agitated with sterile air, incubated at a tank temperature of 27 ° C for 62 to 63 hours, and then introduced into a sterilized culture medium in a fermentation tank, The air was stirred and cultured at a pot temperature of 27 ° C for about 7 to 8 days. ② extraction and refining, fermentation broth by acidification, filtration, to remove mycelium and solids, and then, and through the weak acid cation exchange resin ion exchange, and then dilute sulfuric acid elution to collect high concentrations of elution ─ ─ streptomycin Sulfate solution. The eluent is desalted by sulfonic acid ion exchange resin. At this time, the solution is acidic, neutralized with anionic resin, and decolored by activated carbon to obtain refined liquid (see color chart). The purified liquid is concentrated into a concentrated liquid by a thin film and then spray-dried to obtain a sterile powdery product, or the concentrated liquid is directly made into a water injection.

The pharmacological effects of streptomycin

Streptomycin is an aminoglycoside, active transport through the bacterial cell membrane, and bacterial ribosomal 30S subunit of the special receptor protein binding, interference information RNA and 30S subunits between the initial complex formation, inhibition of protein synthesis. So that DNA misreading, resulting in the synthesis of non-functional protein; polysomnoside and the loss of synthetic protein function, so that a large number of aminoglycoside into the cell, bacterial cell membrane rupture, cell death.

The kinetics of streptomycin

Intramuscular injection of good absorption. Mainly in the extracellular fluid, and can be distributed in all organs and tissues except the brain, the goods reach the cerebrospinal fluid and bronchial secretions in the amount of small; can reach bile, chest, ascites, tuberculous abscess and caseous tissue; High concentration of liquid, can pass through the placental tissue. The distribution volume (Vd) was 0.26 L / kg. Protein binding rate as low as moderate (20 ~ 30%). Intramuscular injection of lg, l ~ 1.5 hours of peak plasma concentration (25 ~ 50μg / ml). T1 / 2 was 2.4 to 2.7 hours, renal dysfunction was 50 to 100 hours. This product is not metabolized in the body, excreted by glomerular filtration, 80 ~ 98% in 24 hours, about 1% from the bile, in addition to a small amount from the milk, saliva and sweat discharge, the product has considerable Hemodialysis clearance.

Streptomycin indications

1, This product is suitable for Tularemia, or in combination with other antimicrobial agents for plague, sexually transmitted diseases, granulomatosis, brucellosis, rat bite fever, can also be combined with penicillin treatment or prevention of Streptococcus viridans or Enterococcus Induced endocarditis.

2, the product can also be combined with other anti-TB drugs for tuberculosis caused by various tuberculosis or other Mycobacterium infection.

3, this product is mainly used in combination with other anti-tuberculosis drugs for tuberculosis caused by a variety of new cases of tuberculosis, or other sensitive Mycobacterium infection.

4, the product can be used alone for the treatment of Tularemia, or in combination with other antimicrobial agents for plague, inguinal granuloma, brucellosis, rat bite fever and other treatment.

5, can also be combined with penicillin or ampicillin treatment of Streptococcus viridans or enterococcus endocarditis caused by.