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 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