General Spectrum of Activity
Pseudomonal and other resistant gram negative infections.
Inhaled form used in cystic fibrosis.
Monitor creatinine at least 2-3 times/week. Discontinue if any signs of ototoxicity.
Extended interval dosing:
In critically ill patients, check peak level after the 1st dose to ensure peak target is obtained and renal function may change rapidly.
First Line Indications
Cystic Fibrosis exacerbation
Can exacerbate neuromuscular blockade
Neuromuscular blockade agents - Respiratory paralysis. Generally do not give IV push.
Restricted to Infectious Diseases and Pulmonary services (Cystic Fibrosis)
Ototoxicity may include both cochlear or vestibular toxicity
Formal audiology assessment if planning to use aminoglycoside for >7d or if symptoms develop. (annual for CF patients who receive IV, q5 years for nebulized tobramycin CF patients)
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
Route of Elimination: Renal