What is Tobramycin
Tobramycin is an aminoglycoside antibiotic obtained from cultures of Streptomyces tenebrarius.
It is most active against aerobic gram-negative rods and, in combination with other antibiotics, is used to treat Staphylococcus aureus and certain species of Streptococcus.
Tobramycin and some other aminoglycosides are used in combination with a penicillin for the treatment of endocarditis. Tobramycin also possesses activity against certain Mycobacterium species but is not active against any anaerobic bacteria.
Some studies suggest that it is less nephrotoxic than gentamicin; however, a difference in incidence of nephrotoxicity has not been firmly established. Tobramycin injection was approved by the FDA in June 1975; tobramycin ophthalmic was approved prior to 1982.
An aerosolized dosage form (TOBI) for the management of cystic fibrosis patients with Pseudomonas infection was given orphan drug designation and was approved by the FDA in December 1997.
Subsequently, two other inhaled formulations have received FDA approval for the management of cystic fibrosis patients >= 6 years old with Pseudomonas aeruginosa, Bethkis (an orally inhaled nebulized solution) approved October 2012 and TOBI Podhaler (an orally inhaled powder) approved March 2013.
Indications
- Acinetobacter calcoaceticus
- Acinetobacter sp.
- Aeromonas sp.
- Bacillus anthracis
- bacteremia
- bacterial conjunctivitis
- blepharitis
- blepharoconjunctivitis
- bone and joint infections
- burn wound infection
- cellulitis
- Citrobacter sp.
- community-acquired pneumonia
- cystic fibrosis
- dacryocystitis
- endocarditis
- Enterobacter sp.
- Enterococcus sp.
- Escherichia coli
- febrile neutropenia
- Haemophilus aegyptius
- Haemophilus influenzae (beta-lactamase negative)
- Haemophilus influenzae (beta-lactamase positive)
- infectious arthritis
- intraabdominal infections
- keratitis
- keratoconjunctivitis
- Klebsiella aerogenes
- Klebsiella pneumoniae
- Klebsiella sp.
- lower respiratory tract infections
- meibomianitis
- meningitis
- Moraxella lacunata
- Morganella morganii
- Neisseria sp.
- nosocomial pneumonia
- osteomyelitis
- peritonitis
- pneumonia
- Proteus mirabilis
- Proteus vulgaris
- Providencia sp.
- Pseudomonas aeruginosa
- Salmonella sp.
- sepsis
- Serratia sp.
- Shigella sp.
- skin and skin structure infections
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis
- Staphylococcus sp.
- Streptococcus pneumoniae
- Streptococcus sp.
- surgical infection prophylaxis
- urinary tract infection (UTI)
- ventriculitis
Side Effects
- abdominal pain
- anaphylactoid reactions
- anemia
- anorexia
- aphonia
- asthenia
- ataxia
- azotemia
- back pain
- bronchospasm
- bullous rash
- chest pain (unspecified)
- confusion
- cough
- cylindruria
- diarrhea
- dizziness
- dysgeusia
- dysphonia
- dyspnea
- elevated hepatic enzymes
- eosinophilia
- epistaxis
- erythema
- erythema multiforme
- exfoliative dermatitis
- fever
- headache
- hearing loss
- hemoptysis
- hyperbilirubinemia
- hyperventilation
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hyposthenuria
- impaired wound healing
- injection site reaction
- laryngitis
- lethargy
- leukocytosis
- leukopenia
- malaise
- myalgia
- myasthenia
- nasal congestion
- nausea
- nephrotoxicity
- neurotoxicity
- ocular irritation
- ocular pruritus
- otalgia
- ototoxicity
- pharyngitis
- proteinuria
- pruritus
- pseudomembranous colitis
- pyuria
- rash
- renal tubular acidosis (RTA)
- renal tubular necrosis
- rhinitis
- seizures
- sinusitis
- Stevens-Johnson syndrome
- superinfection
- throat irritation
- thrombocytopenia
- tinnitus
- toxic epidermal necrolysis
- urticaria
- vertigo
- vitamin B12 deficiency
- vitamin B6 deficiency
- vomiting
- weakness
- weight loss
- wheezing
Monitoring Parameters
- audiometry
- serum aminoglycoside concentrations
- serum creatinine/BUN
Contraindications
- acute bronchospasm
- aminoglycoside hypersensitivity
- botulism
- breast-feeding
- colitis
- corneal abrasion
- dehydration
- diabetes mellitus
- diarrhea
- electrolyte imbalance
- geriatric
- GI disease
- hearing impairment
- inflammatory bowel disease
- myasthenia gravis
- neonates
- nephrotoxicity
- neuromuscular disease
- neurotoxicity
- ototoxicity
- parkinsonism
- pregnancy
- premature neonates
- pseudomembranous colitis
- renal disease
- renal failure
- renal impairment
- respiratory depression
- respiratory insufficiency
- serious rash
- tinnitus
- ulcerative colitis
Interactions
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Diphenhydramine
- Acyclovir
- Adefovir
- Aldesleukin, IL-2
- Aminosalicylate sodium, Aminosalicylic acid
- Amobarbital
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Aprotinin
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atracurium
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine; Fluticasone
- Bacitracin
- Beclomethasone
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Betamethasone
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Bismuth Subsalicylate
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bleomycin
- Botulinum Toxins
- Budesonide
- Budesonide; Formoterol
- Bumetanide
- Capreomycin
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carboplatin
- Cefepime
- Cefotaxime
- Cefotetan
- Cefoxitin
- Cefprozil
- Ceftazidime
- Ceftazidime; Avibactam
- Ceftizoxime
- Cefuroxime
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Choline Salicylate; Magnesium Salicylate
- Ciclesonide
- Cidofovir
- Cisatracurium
- Cisplatin
- Clofarabine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Corticosteroids
- Corticotropin, ACTH
- Cortisone
- Cyclizine
- Cyclosporine
- Daptomycin
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Deferasirox
- Deflazacort
- Dexamethasone
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Promethazine
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxacurium
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir alafenamide
- Emtricitabine; Tenofovir disoproxil fumarate
- Entecavir
- Ethacrynic Acid
- Fludrocortisone
- Flunisolide
- Fluphenazine
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Foscarnet
- Furosemide
- Gallium
- Gallium Ga 68 Dotatate
- Ganciclovir
- General anesthetics
- Ginger, Zingiber officinale
- Gold
- Hyaluronidase, Recombinant; Immune Globulin
- Hydrocortisone
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibandronate
- Ibuprofen lysine
- Immune Globulin IV, IVIG, IGIV
- Inotersen
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
- Isosulfan Blue
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lithium
- Magnesium Salicylate
- Mannitol
- Meclizine
- Meperidine; Promethazine
- Mesoridazine
- Methohexital
- Methylprednisolone
- Mivacurium
- Mometasone
- Mycophenolate
- Neuromuscular blockers
- Non-Ionic Contrast Media
- Nonsteroidal antiinflammatory drugs
- Oral Contraceptives
- Pamidronate
- Pancuronium
- Pentamidine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenylephrine; Promethazine
- Polymyxin B
- Polymyxins
- Prednisolone
- Prednisone
- Promethazine
- Pyridostigmine
- Rapacuronium
- Rocuronium
- Salicylates
- Salsalate
- Scopolamine
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Streptozocin
- Succinylcholine
- Surfactants
- Tacrolimus
- Telavancin
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Thioridazine
- Tolvaptan
- Torsemide
- Triamcinolone
- Trifluoperazine
- Trimethobenzamide
- Tubocurarine
- Urea
- Valacyclovir
- Valganciclovir
- Vancomycin
- Vecuronium
- Warfarin
- Zalcitabine, ddC
- Zoledronic Acid