Toxicity monitoring for streptomycin therapy relies on which laboratory values?

• A. ALT/AST
• B. BUN and creatinine
• C. Platelet count
• D. Hemoglobin

Answer: (B)

Streptomycin is an aminoglycoside, and its major toxicity concern is nephrotoxicity (kidney damage) as well as ototoxicity. Because the kidneys handle the drug, monitoring how well the kidneys are working is essential during therapy. BUN (blood urea nitrogen) and creatinine are direct indicators of renal function; elevations suggest impaired kidney function and potential nephrotoxicity from the drug, signaling the need to adjust or discontinue therapy.

ALT and AST are liver enzymes, so they reflect liver injury rather than the kidney toxicity most associated with streptomycin. Platelet count and hemoglobin monitor blood cell lines and aren’t the primary concerns with this antibiotic, since drops in those values are not typical or the main reason to track toxicity for streptomycin.