Tobramycin Sulfate(toe bra mye’ sin)
Parenteral: generic
Nebulizer solution: TOBI, TOBI Podhaler
Ophthalmic: Tobrex Ophthalmic, Tobrasol
PREGNANCY CATEGORY D
(INJECTION, INHALATION)
PREGNANCY CATEGORY B
(OPHTHALMIC)
Drug class
Aminoglycoside antibiotic
Therapeutic Actions
Bactericidal: Inhibits protein synthesis in susceptible strains of gram-negative bacteria; mechanism of lethal action is not fully understood, but functional integrity of bacterial cell membrane appears to be disrupted.
Indications
Parenteral: Treatment of serious infections caused by susceptible strains of Pseudomonas aeruginosa, Proteus species, Providencia species, Escherichia coli, Klebsiella-Enterobacter-Serratia group, Citrobacter species, and staphylococci (including Staphylococcus aureus)
Treatment of staphylococcal infections when penicillin is contraindicated or when the bacteria are not susceptible
Treatment of serious, life-threatening, gram-negative infections when susceptibility studies have not been completed (sometimes concurrent penicillin or cephalosporin therapy)
Nebulizer solution: Management of cystic fibrosis patients with P. aeruginosa
Ophthalmic: Treatment of superficial ocular infections due to susceptible strains of organisms
Contraindications and Cautions
Contraindicated with hypersensitivity to aminoglycosides; pregnancy, lactation.
Available Forms
Injection—0.8, 1.2, 10, 40 mg/mL, 80 mg/100 mL normal saline; nebulizer solution—300 mg/5 mL; nebulizer inhalation capsules—28 mg; ophthalmic solution—0.3%; ophthalmic ointment—3 mg/g
Dosages
IM or IV
Doses based on ideal body weight.
Dosages
Adults
3 mg/kg/day IM or IV in three equal doses every 8 hr. Up to 5 mg/kg/day in three to four equal doses can be used in life-threatening infections, but reduce to 3 mg/kg/day as soon as possible. Do not exceed 5 mg/kg/day unless serum levels are monitored.
Pediatric patients older than 1 wk
6–7.5 mg/kg/day IM or IV in three to four equally divided doses.
Premature infants or neonates 1 wk and younger
Up to 4 mg/kg/day IM or IV in two equal doses every 12 hr.
Geriatric patients or patients with renal failure
Reduce dosage, and carefully monitor serum drug levels and renal function tests throughout treatment. Reduced dosage nomogram is available; check manufacturer’s information.
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