Streptomycin has largely been replaced by newer aminoglycosides for most Gram-negative infections, but it retains a defined therapeutic niche. For which pair of infections does streptomycin remain a recognized drug of choice or first-line parenteral agent?

• A Typhoid fever and shigellosis
• B Legionnaires disease and Q fever
• C Plague and tularemia ✓
• D Relapsing fever and leptospirosis

Explanation

Streptomycin remains a drug of choice for plague caused by Yersinia pestis and for tularemia caused by Francisella tularensis, both zoonotic infections for which it is bactericidal and clinically proven. It is also used as a second-line agent in tuberculosis and historically in enterococcal endocarditis combinations. Typhoid is treated with ceftriaxone or azithromycin, Legionella with macrolides or fluoroquinolones, and leptospirosis with penicillin or doxycycline, so those options fall outside its spectrum.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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