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.

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 recommended 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