A 24-year-old pregnant woman at 14 weeks gestation is diagnosed with sputum-positive pulmonary tuberculosis. She has severe liver disease precluding pyrazinamide. Which injectable agent must be avoided because it crosses the placenta and causes congenital deafness?

• A Amikacin
• B Capreomycin
• C Levofloxacin
• D Streptomycin ✓

Explanation

Streptomycin crosses the placenta and has caused bilateral congenital sensorineural deafness, so it is contraindicated in pregnancy. All aminoglycosides carry some fetal ototoxicity risk, but streptomycin carries the clearest documented evidence and is the classic exam answer. Fluoroquinolones are relatively avoided too, but their concern is cartilage effects rather than deafness.

Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.