Tobramycin

Indications & Dose:

Septicaemia | Meningitis and other CNS infections, Biliarytract infection, Acute pyelonephritis or prostatitis ,Pneumonia in hospital patients 

• BY INTRAMUSCULAR INJECTION, OR BY SLOW INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION

Adult: 3 mg/kg daily in 3 divided doses; increased if necessary up to 5 mg/kg daily in 3–4 divided doses, increased dose used in severe infection; dose to be reduced back to 3 mg/kg daily as soon as clinically indicated Urinary-tract infection 

• BY INTRAMUSCULAR INJECTION 

Adult: 2–3 mg/kg for 1 dose

Chronic Pseudomonas aeruginosa infection in patients with cystic fibrosis

DOSES AT EXTREMES OF BODY-WEIGHT

To avoid excessive dosage in obese patients, use ideal weight for height to calculate parenteral dose and monitor serum-tobramycin concentration closely.

Children

Neonates upto 4mg/kg daily in 2 equal doses; others 6-7.5mg/kg daily in 3-4 divided doses

Contraindications:

Hypersensitivity. Pregnancy.

Side Effects:

Common or very common

When used by inhalation Malaise . rhinitis . tinnitus

Uncommon

With systemic use Rash Rare When used by inhalation Aphonia . hearing loss Very rare

When used by inhalation Pruritus . urticaria Frequency not known

When used by inhalation Bronchospasm . cough (more frequent by inhalation of powder) . dysphonia . epistaxis . haemoptysis . laryngitis . mouth ulcers . pharyngitis . salivary hypersecretion . taste disturbances

Cautions:

When used by inhalation Conditions characterised by muscular weakness—may impair neuromuscular transmission . history of prolonged previous or concomitant intravenous aminoglycosides—increased risk of ototoxicity . renal impairment—limited information available . severe haemoptysis—risk of further haemorrhage

Precautions:

Interaction:

 Same as gentamycin.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: