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Antimicrobials
Tobramycin

Tobramycin

C difficile risk
Low
Oral Bioavailability
N/A

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Adult

Refer to order set 10-111-5336

Renal

Refer to order set 10-111-5336

No Data

General Information

Order Set

Common Usage

Pseudomonal and other gram negative infections.

Inhaled form used in cystic fibrosis.

Drug Monitoring

Refer to order set 10-111-5336 for necessary bloodwork.

Serum levels will be reviewed and managed by site/ward pharmacists as per policy.

Adverse Effects

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

Major Interactions

Increased nephrotoxicity

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

Increased ototoxicity

  • Furosemide

Neuromuscular blockade agents - Respiratory paralysis

Additional Information

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.

Pharmacology

Antimicrobial class: Aminoglycoside

Pregnancy category: D

Average serum half life: 3 hours

Biliary penetration: Moderate

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Therapeutic