A Review on the Discovery, Pharmacology, and Clinical Significance of Streptomycin

Review Article

Abstract

Streptomycin, isolated in 1943 from the actinobacterium Streptomyces griseus, was the first aminoglycoside antibiotic discovered and regarded as a landmark in modern medicine. Its introduction provided the first effective chemotherapy against Mycobacterium tuberculosis, revolutionizing the treatment of tuberculosis. The molecule is a bactericidal agent that functions by irreversibly binding to the 16S rRNA of the bacterial 30S ribosomal subunit. This binding interferes with translational initiation and promotes the misreading of mRNA, leading to the synthesis of non-functional proteins that disrupt cell membrane integrity. Pharmacokinetically, streptomycin is a highly polar molecule, resulting in negligible gastrointestinal absorption and necessitating parenteral administration. It distributes primarily within the extracellular fluid and is eliminated unchanged via glomerular filtration. Its clinical utility is concentration-dependent and benefits from a significant post-antibiotic effect. Despite its historical importance, systemic use is now limited by significant toxicities, primarily irreversible ototoxicity and reversible nephrotoxicity. Today, streptomycin retains a critical, specialized role in combination therapy for multidrug-resistant tuberculosis, specific zoonotic infections such as plague and tularemia, and in synergistic regimens for bacterial endocarditis