Streptomycin

FDA

• Mycobacterium tuberculosis
  • An infrequently used alternative component of combination therapy when susceptibility is demonstrated and preferred oral agents are unavailable or not feasible.
• Yersinia pestis (plague)
• Francisella tularensis (tularemia)
  • 2025 CDC tularemia recommendations relegate streptomycin to third-tier treatment because of toxicity, limited availability, and unfamiliarity with its preparation and administration.
• Brucella infection
  • Used in combination with doxycycline
• Historical FDA indications: Streptomycin is not generally used for these infections because safer and more effective alternatives are available.
  • Klebsiella granulomatis (Donovanosis, granuloma inguinale)
  • Haemophilus ducreyi (chancroid); Haemophilus influenzae
  • Urinary tract infections
  • Gram-negative bacillary bacteremia (concomitantly with another antibacterial agent)
  • Enterococcal endocarditis
    
    • The 2026 AHA statement favors ampicillin plus ceftriaxone for susceptible E. faecalis endocarditis; streptomycin is not included among its recommended regimens[10].