toxylact: a07aa04 streptomycin
The first professional lActological database in the word
A07AA04 corresponds to streptomycin, an intestinal anti-infective antibiotic in the ATC system; for a web-page style summary, it can be presented as a locally acting gastrointestinal antibacterial with breastfeeding use generally regarded as acceptable with infant monitoring, although the evidence base is limited
Pharmacological class and mechanism
Streptomycin in ATC class A07AA04 belongs to the subgroup of intestinal antibiotics within antidiarrheal and intestinal anti-infective agents. It is an aminoglycoside antibiotic that inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit, producing bactericidal activity against susceptible organisms.
When used for intestinal indications, its intended effect is mainly within the gastrointestinal lumen, although streptomycin is better known clinically for systemic use in serious infections such as tuberculosis, plague, brucellosis, and tularemia. This distinction is important in toxicological and lactation assessment because systemic exposure is the main determinant of maternal and infant risk
Therapeutic use and safety
As an intestinal anti-infective, A07AA04 is classified on the basis of treatment of intestinal infections. In broader clinical use, streptomycin is reserved for selected serious bacterial infections because of its toxicity profile and the availability of safer alternatives in many settings
The principal toxicological concerns with streptomycin are ototoxicity, vestibular toxicity, nephrotoxicity, and neuromuscular effects, which are characteristic of aminoglycosides. These risks are most relevant with systemic exposure, prolonged treatment, renal impairment, or concomitant use of other ototoxic or nephrotoxic drugs
Lactation toxicology
LactMed states that, like other aminoglycosides, streptomycin is poorly excreted into breast milk. Because aminoglycosides are also poorly absorbed orally, the amount reaching the infant’s systemic circulation after ingestion through milk is expected to be very llow
Additional lactation references describe streptomycin as compatible or relatively safe during breastfeeding, and some clinical sources state that available human data suggest minimal risk to the nursing infant. At the same time, product-oriented references still recommend clinical caution and individualized benefit-risk assessment.
Breastfeeding recommendations
Breastfeeding usually does not need to be interrupted during maternal streptomycin therapy when treatment is clinically necessary. However, the infant should be observed for changes in gastrointestinal tolerance, including diarrhea, candidiasis, or altered feeding behavior, as precautionary monitoring is commonly advised for maternal antibiotic use.
Extra caution is reasonable in premature infants, neonates, or infants with gastrointestinal disease, because these groups may be more vulnerable even when milk transfer is low. If prolonged maternal therapy or high systemic exposure is expected, treatment choice should be guided primarily by clinical need, while lactation safety remains a secondary but important consideration.
