Tobramycin

KEY POINTS

• Tobramycin is an aminoglycoside antibiotic that inhibits bacterial growth in susceptible organisms by interfering with bacterial protein synthesis
  • Binds to 30S and 50S ribosomal subunits, resulting in a defective bacterial cell membrane
  • Exhibit concentration-dependent bacterial killing (higher peak levels means more bacterial killing)
  • Has activity against many organisms, including susceptible Pseudomonas aeruginosa 
• May be given via the intravenous, inhaled, intrathecal or topical route
  • Is at times mixed in cement and used during orthopedic surgery
• Nephrotoxicity and ototoxicity are potential side effects of IV tobramycin
  • Adjust IV tobramycin doses & frequency for kidney impairment
  • Monitoring drug levels may be indicated
• Beware bronchospasm with inhaled tobramycin

RESOURCES

• Tobramycin IV Package Insert
• Inhaled Tobramycin Package Insert (Teva)
• Inhaled Tobramycin Package Insert (Bethkis)
• Inhaled Tobramycin Package Insert (TOBI)
• Inhaled Tobramycin Package Insert (TOBI Podhaler)
• Proper Use Inhaled Tobramycin (Mayo Clinic)
• Nebraska Stewardship Program PK Training Content
• PK-PD Compass
• IDSA Practice Guidelines
• Surgical Prophylaxis Guidelines