<s>[INST] context: STREPTOMYCIN It is the oldest aminoglycoside antibiotic obtained from Streptomyces griseus; used extensively in the past, but now practically restricted to treatment of tuberculosis. Streptomycin has the lowest nephrotoxicity among aminoglycosides; probably because it is not concentrated in the renal coex. Hypersensitivity reactions are rare; rashes, eosinophilia.Popularity of S in the treatment of tubercu: osis had declined due to need for i.m. injections .md lower margin of safety, because of ototoxicity and nephrotoxicity, especially in the elderly and in those with impaired renal function. Patient acceptability of E is very good and side effects are few. Loss of visual acuity I colour vision. field defects due to optic neuritis is the most impoant dose and duration of therapy dependent toxicity. Because young children ma,be unable to repo early visual impairment, it should not be used below 6 years of age. With early recognition and stoppage of therapy, visual toxicity is largely reversible. Adverse effects INH is well tolerated by most patients. Peripheral neuritis and a variety of neurological manifestations (paresthesias, numbness, mental disturbances, rarely convulsions) are the most impoant dose-dependent toxic effects. These are due to interference with utilization of pyridoxine and its increased excretion in urine.Hepatitis, a major adverse effect of iNH, is rare in children, but more common in older people and in alcoholics. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:741,743 [/INST] question: Drug that is not used in renal failure is: ( | options: A: Ethambutol B: Rifampicin C: Isoniazid D: Streptomycin | answer: D </s>