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Tobramycin

Brand and Other Names: TOBRAMYCIN
Mechanism of Action:

Tobramycin acts by inhibiting synthesis of protein in bacterial cells. In vitro tests demonstrate that tobramycin is bactericidal.

Indications:

Tobramycin is indicated for the treatment of serious bacterial infections caused by susceptible strains of the designated microorganisms in the diseases listed below:

  • Septicemia in the pediatric patient and adults caused by P. aeruginosa, E. coli, and Klebsiella species (spp);
  • Lower respiratory tract infections caused by P. aeruginosa, Klebsiella spp, Enterobacter spp, Serratia spp, E. coli, and S. aureus;
  • Serious central nervous system infections (meningitis) caused by susceptible organisms;
  • Intra-abdominal infections, including peritonitis, caused by E. coli, Klebsiella spp., and Enterobacter spp;
  • Skin, bone, and skin structure infections caused by P. aeruginosa, Proteus spp, E. coli, Klebsiella spp., Enterobacter spp., and S. aureus

See Full Prescribing Information.

Route: Intravenous
Dose:
Recommended adult dosages are as follows: Serious Infections: Administer 3 mg/kg/day in 3 equal doses (i.e.1 mg/kg every 8 hours); Life-threatening Infections: Administer up to 5 mg/kg in 3 or 4 equal doses; See full prescribing information for the recommended dosage for pediatric patients, patients with cystic fibrosis, patients with renal impairment, and obese patients.
Adverse Reactions:
Most common adverse reactions are ototoxicity and nephrotoxicity.
Contraindication:

A hypersensitivity to any aminoglycoside is a contraindication to the use of tobramycin. A history of hypersensitivity or serious toxic reactions to aminoglycosides may also contraindicate the use of any other aminoglycoside because of the known crosssensitivity of patients to drugs in this class.

Warnings and Precautions:

Nephrotoxicity, Ototoxicity and Embryo-Fetal Toxicity: See Boxed Warning.

Allergic Reactions: anaphylaxis, exfoliative dermatitis, toxic epidermal necrolysis, erythema multiforme, and Stevens-Johnson Syndrome have been reported in patients on tobramycin therapy. If an allergic reaction occurs, discontinue the drug and institute appropriate therapy.

Neuromuscular Blockade: Respiratory paralysis can occur at high doses or with concurrent use of neuromuscular blocking agents. If neuromuscular blockade occurs, consider administration of calcium salts but mechanical assistance may be necessary.

Clostridioides difficile-associated diarrhea (CDAD): Evaluate patients if diarrhea occurs.

See package insert for full prescribing information.