Antimicrobials
Tobramycin

Tobramycin

Low
N/A
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General Information

Pseudomonal and other gram-negative infections.

Inhaled form used in cystic fibrosis

Laboratory Monitor creatinine at least 2 times/week. Discontinue if any signs of nephro- or ototoxicity.

For traditional dosing: Target Peak 8-10 ug/mL, Trough <1 ug/mL.

For extended interval dosing: Target Trough <1 ug/mL

Note: trough level is 0-60min before a dose (usually pre-4th), and peak is 30-60min after dose infused (usually post-3rd).

In critically ill patients, check peak level after the 1st dose as volume of distribution and renal function may change rapidly.

Clinical Baseline and periodic hearing and vestibular function (questioning audiologic testingwith prolonged therapy)

  • Nephrotoxicity
  • Auditory toxicity
  • Vestibular toxicity
  • Neuromuscular blockade

Increased nephrotoxicity with: 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 to report any symptoms

Antimicrobial class: Aminoglycoside

Pregnancy category: D

Average serum half life: 3 hours

Biliary penetration: Moderate

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Therapeutic