Pseudomonal and other gram negative infections.
Monitor creatinine at least 3 times/week. Discontinue if any signs of ototoxicity.
For multiple daily dosing:
For once daily dosing:
Inhaled tobramycin (using IV formulation): 80mg inhaled BID
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
Increased nephrotoxicity
Increased ototoxicity
Neuromuscular blockade agents - Respiratory paralysis.
Antimicrobial class: Aminoglycoside
Pregnancy category: D (short courses during pregnancy have been demonstrated as safe)
Average serum half life: 3 hours
Biliary penetration: Moderate
CSF penetration: Poor
Lung penetration: Therapeutic
Urine penetration: Therapeutic