Intramuscular Route Only Adults: The preferred site is the upper outer quadrant of the buttock, (i.e., gluteus maximus), or themid-lateral thigh. Children: It is recommended that intramuscular injections be given preferably in the mid-lateral muscles of the thigh. In infants and small children the periphery of the upper outer quadrant of the gluteal region should be used only when necessary, such as in burn patients, in order to minimize the possibility of damage to the sciatic nerve. 1. TUBERCULOSIS: Children daily - 20-40 mg/kg Adults daily - 15 mg/kg Streptomycin is usually administered daily as a single intramuscular injection. A total dose of not more than 120 g over the course of therapy should be given unless there are no other therapeutic options. 2. TULAREMIA: One to 2 g daily in divided doses for 7 to 14 days until the patient is afebrile for 5 to 7 days. 3. PLAGUE: Two grams of Streptomycin daily in two divided doses should be administered intramuscularly. A minimum of 10 days of therapy is recommended. 4. BACTERIAL ENDOCARDITIS: a. Streptococcal endocarditis; in penicillin-sensitive alpha and non-hemolytic streptococcal endocarditis (penicillin MIC<0.1 mcg/mL), Streptomycin may be used for 2-week treatment concomitantly with penicillin. The Streptomycin regimen is 1 g b.i.d. for the first week, and 500 mg b.i.d. for the second week. If the patient is over 60 years of age, the dosage should be 500 mg b.i.d. for the entire 2- week period. b. Enterococcal endocarditis: Streptomycin in doses of 1 g b.i.d. for 2 weeks and 500 mg b.i.d. for an additional 4 weeks is given in combination with penicillin. Ototoxicity may require termination of the Streptomycin prior to completion of the 6-week course of treatment. 5. CONCOMITANT USE WITH OTHER AGENTS: For concomitant use with other agents to which the infecting organism is also sensitive: Streptomycin is considered a secondline agent for the treatment of gram-negative bacillary bactermia, meningitis, and pneumonia; brucellosis; granuloma inguinale; chancroid, and urinary tract infection. For adults: 1 to 2 grams in divided doses every six to twelve hours for moderate to severe infections. Doses should generally not exceed 2 grams per day. For children: 20 to 40 mg/kg/day (8 to 20 mg/lb/day) in divided doses every 6 to 12 hours. (Particular care should be taken to avoid excessive dosage in children).

At 5 and 50 ug/ml, streptomycin inhibited the tubercle bacilli strongly and killed some; at the lowest tested concentration of 0.5 ug/ml, it inhibited them weakly.