Antimicrobials
Tobramycin

Tobramycin

Low
N/A

Dosing

General Information

Pseudomonal and other gram negative infections.

Inhaled form used in cystic fibrosis.

Monitor creatinine at least 3 times/week. Discontinue if any signs of ototoxicity.

Pharmacist will consult, adjust doses and order serum drug levels and renal function monitoring as per MSH Policy.

For indication specific peak and trough target levels, please refer to MSH Aminoglycoside Policy and consult pharmacy.

Nephrotoxicity (non-oliguric)

  •  Avoid concomitant nephrotoxins
  •  Less common with once daily dosing
  •  Greater toxicity with longer duration and supratherapeutic trough levels

Vestibulocochlear toxicity

  • Irreversible
  • Require audiology testing if prolonged use

Can exacerbate neuromuscular blockade

  •  Contraindicated in patients with myasthenia gravis.

Increased nephrotoxicity

  •  Amphotericin B
  •  Cyclosporine
  •  Cisplatin
  •  NSAIDS
  •  Contrast dye
  •  Vancomycin

Increased ototoxicity

  •  Furosemide

Neuromuscular blockade agents - Respiratory paralysis.

Formal audiology assessment if planning to use aminoglycoside for >7d or if symptoms develop.

Inform patient of risk of ototoxicity and to report any symptoms

Antimicrobial class: Aminoglycoside

Pregnancy category: D

Average serum half life: 3 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Moderate