Tobramycin

Type of Medication: Antibiotic

Indications: Treatment of Pseudomonas aeruginosa and Burkholderia cepacia respiratory infections. Prophylaxis for Pseudomonas aeruginosa infection.

Side Effects: Vestibular and auditory damage, nephrotoxicity, hypomagnesaemia, hypokalemia,antibiotic associated colitis, nausea, vomiting,diarrhoea, hypersensitivity (fever, rash), raised LFT and bilirubin,haematological disorders,headaches, confusion.

Route of administration: Adult (Intravenous)

Dose:10 mg/kg/24 hrs given as a single dose or as three separate doses.

Administration: Once daily dosing: take trough concentration immediately before next dose is due. Ensure trough is less than 1mg/litre. Give dose over 30 – 60 mins in 50ml – 100 mls sodium chloride 0.9%. Three times a day dosing: ensure trough is less 2 mg/litre, peak at one hour is 8-12mg/litre. Give dose as bolus or in 50ml NaCl 0.9% over 15 mins

Route of administration: Paediatric (Intravenous)

Dose:12 mg/kg/day in 3 divided doses or 10 mg/kg/day as a single dose. Titrate according to levels.

Administration: As for adults

Examples of some Drug Interactions

Interacting drug: Amphotericin – increased risk of nephrotoxicity

Interacting drug: Bisphosphonates – increased risk of hypocalcaemia

Interacting drug: Colistin – increased risk of nephrotoxicity

Interacting drug: Cyclosporin – increased risk of nephrotoxicity

Interacting drug: Loop diuretics – increased risk of ototoxicity

Interacting drug: Muscle relaxants – enhanced effect

Interacting drug: Tacrolimus – increased risk of nephrotoxicity

Interacting drug: vancomycin and teicoplanin – Increased risk of nephrotoxicity and ototoxicity