Tobramycin Inj Rx
Generic Name and Formulations:
Tobramycin sulfate 10mg/mL, 40mg/mL; soln for IM inj or IV infusion after dilution; contains 1.56mg sodium per 20mg/mL vial; contains sulfites.
Various generic manufacturers
Indications for Tobramycin Inj:
Serious susceptible infections, including lower respiratory tract, CNS (eg, meningitis), intraabdominal (eg, peritonitis), septicemia, bone, skin and skin structure, complicated and recurrent UTIs or uncomplicated UTIs not susceptible to other antibiotics.
Obesity: base dose on lean body mass. Give by IM inj; or IV infusion over 20–60 mins. Serious infections: 3mg/kg/day in 3 divided doses every 8 hours. Life-threatening infections: up to 5mg/kg/day in 3–4 divided doses; max 5mg/kg/day unless serum levels monitored; reduce to 3mg/kg/day as soon as clinically indicated. Usual duration: 7–10 days. Severe cystic fibrosis: initially 10mg/kg/day in 4 divided doses; adjust dose based on serum levels. Renal impairment: reduce dose; see literature.
Give by IM inj; or IV infusion over 20–60 mins. Premature or neonates ≤1 week: up to 4mg/kg/day in 2 divided doses every 12 hours. All others >1 week: 6–7.5mg/kg/day in 3–4 divided doses (2–2.5mg/kg every 8 hours or 1.5–1.89mg/kg every 6 hours). Usual duration: 7–10 days. Renal impairment: reduce dose; see literature.
Monitor for nephro- and neurotoxicity; avoid peak serum levels >12micrograms/mL and trough levels >2micrograms/mL. Discontinue or adjust dose if auditory, vestibular, or renal dysfunction develops; monitor serum levels periodically. Do audiogram in high-risk patients. Maintain adequate hydration. Prolonged use or excessive doses. Asthma. Muscular disorders (eg, myasthenia gravis, parkinsonism). Elderly. Premature or neonatal infants. Pregnancy (Cat.D): not recommended.
Avoid concomitant furosemide, ethacrynic acid, other nephro/neurotoxic drugs including cephalosporins. Diuretics may increase toxicity. May potentiate neuromuscular blocking agents.
Nephro- or neurotoxicity, lethargy, confusion, headache, inj site reactions, GI upset, elevated liver enzymes, blood dyscrasias, electrolyte abnormalities, respiratory failure or paralysis, neuromuscular blockade; rare: serious allergic reactions (eg, anaphylaxis, exfoliative dermatitis, Stevens-Johnson Syndrome).
Formerly known under the brand name Nebcin.
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