|
Tobramycin sulfate
Tobramycin sulfate (Nebcin)
Tobramycin sulfate
(toe-brah-
MY-sin)
Pregnancy Category: D (B for ophthalmic use)
Inhalation: TOBI
Parenteral: Nebcin
Nebcin Pediatric
Ophthalmic: AKTob Ophthalmic Solution
Tobrex Ophthalmic Ointment
Tobrex Ophthalmic Solution
(Rx)
Classification:
Antibiotic, aminoglycoside
See Also:
See also
Aminoglycosides
[.
]
Action/Kinetics:
Similar to gentamicin and can be used concurrently with carbenicillin.
Therapeutic serum levels: IM, 4-8 mcg/mL.
t
1/2: 2-2.5 hr.
Toxic serum levels: > 12 mcg/mL (peak) and > 2 mcg/mL (trough).
Uses:
Systemic: (1) Complicated and recurrent UTIs due to
Pseudomonas aeruginosa, Proteus, Escherichia coli, Klebsiella, Enterobacter, Serratia, Staphylococcus aureus, Citrobacter and
Providencia. (2) Lower respiratory tract infections due to
P. aeruginosa, Klebsiella, Enterobacter, E. coli, Serratia and
S. aureus (penicillinase- and non-penicillinase producing). (3) Intra-abdominal infections (including peritonitis) due to
E. coli, Klebsiella and
Enterobacter. (4) Septicemia in neonates, children, and adults due to
P. aeruginosa, E. coli and
Klebsiella. (5) Skin, bone, and skin structure infections due to
P. aeruginosa, Proteus, E. coli, Klebsiella, Enterobacter and
S. aureus. (6) Serious CNS infections, including meningitis. Can be used with penicillins or cephalosporins in serious infections when results of susceptibility testing are not yet known.
Ophthalmic: Treat superficial ocular infections due to
Staphylococcus, S. aureus, Streptococcus, S. pneumoniae beta-hemolytic streptococci,
Corynebacterium, E. coli, Haemophilus aegyptius, H. ducreyi, H. influenzae, H. parainfluenzae, Klebsiella pneumoniae, Neisseria, N. gonorrhoeae, Proteus, Acinetobacter calcoaceticus, Enterobacter, Enterobacter aerogenes, Serratia marcescens, Moraxella, Pseudomonas aeruginosa and
Vibrio.
Inhalation: Management of lung infections (
P. aeruginosa) in cystic fibrosis clients
.
Contraindications:
Ophthalmically to treat dendritic keratitis, vaccinia, varicella, fungal or mycobacterial eye infections, after removal of a corneal foreign body. Lactation.
Special Concerns:
Use with caution in premature infants and neonates. Ophthalmic ointment may retard corneal epithelial healing.
Additional Side Effects:
Ophthalmic use: Transient irritation, burning, stinging, itching, inflammation, angioneurotic edema, urticaria, vesicular and maculopapular dermatitis.
Overdose Management:
Symptoms (Ophthalmic Use): Edema, lid itching, punctate keratitis, erythema, lacrimation.
Additional Drug Interactions:
Carbenicillin or ticarcillin:
 Tobramycin effect when used for
Pseudomonas infections.
How Supplied:
Inhalation Solution: 60 mg/mL;
Injection: 10 mg/mL, 40 mg/mL;
Powder for injection: 60 mg, 80 mg, 1.2 g;
Ophthalmic Ointment: 0.3%;
Ophthalmic Solution: 0.3%
Dosage
?IM, IV
Non-life-threatening serious infections.
Adults: 3 mg/kg/day in three equally divided doses q 8 hr.
Life-threatening infections.
Up to 5 mg/kg/day in three or four equal doses.
Pediatric: Either 2-2.5 mg/kg q 8 hr or 1.5-1.9 mg/kg q 6 hr;
neonates 1 week of age or less: up to 4 mg/kg/day in two equal doses q 12 hr.
Impaired renal function.
Initially: 1 mg/kg;
then, maintenance dose calculated according to information supplied by manufacturer.
?Ophthalmic Ointment (0.3%)
Acute infections.
0.5-in. ribbon q 3-4 hr until improvement is noted.
Mild to moderate infections.
0.5-in. ribbon b.i.d.-t.i.d.
?Ophthalmic Solution (0.3%)
Acute infections.
Initial: 1-2 gtt q 15-30 min until improvement noted;
then, reduce dosage gradually.
Moderate infections.
1-2 gtt 2-6 times/day.
?Inhalation Solution
Pseudomonas aeruginosa in cystic fibrosis.
Dose using a nebulizer b.i.d. for 10-15 min in cycles of 28 days on and then 28 days off. See package insert for detailed instructions for administration. |
