Antimicrobials
Tobramycin

Tobramycin

Dosing

General Information

Family history of hearing loss.

  • Nephrotoxicity (non-oliguric)- less common with once daily dosing; greater risk with durations beyond 10 days and higher trough levels
  • Vestibulocochlear toxicity (irreversible)
  • Can exacerbate neuromuscular blockade- e.g. contraindicated in patients with myasthenia gravis.

Enhanced nephrotoxic effect with concomitant use of other nephrotoxic drugs such as vancomycin, loop diuretics (e.g. furosemide).

Non-depolarizing muscle relaxants may be potentiated.

Urinary tract infection suspected due to a Gram negative pathogen such as E. coli, Klebsiella or Pseudomonas

When checking level, administer next dose as scheduled unless clinical concern for renal dysfunction or hearing/vestibular abnormalities.

NOTE: For frequency adjustment due to renal dysfunction, consult clinical pharmacist.

  • Baseline serum creatinine. If normal and stable, repeat once weekly.
  • Recommended tobramycin level(s) as above. Once targeted levels achieved and serum creatinine stable, repeat once weekly.
  • Audiology consult recommended if IV aminoglycoside therapy is expected to continue for greater than 10 days. Repeat every 7 days.

Not applicable