Meds and you

Updated 11 February 2013

Tobramycin

Tobramycin is a broad-spectrum antibiotic.

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Tobramycin is the active ingredient of Micro Tobramycin, Nebcin, Tobramycin Sulphate Fresenius, and Tobrex.

Tobramycin is also one of multiple active ingredients found in Tobradex.

General information

Tobramycin is a broad-spectrum antibiotic. It is however not effective in treating anaerobic infections - infections occurring in the absence of oxygen - and is often combined with other antibiotics to extend its spectrum of efficacy.

Tobramycin 'teams up ' favourably with penicillin antibiotics; penicillin weakens bacterial cell walls, thereby granting tobramycin access into bacterial cells.

This antibiotic is poorly absorbed when taken by mouth and is generally only used as injection or as a topical application.

Tobramycin is effective in treating infections of the lungs, urinary tract, bones and joints, soft tissue, eye, ear and intra-abdominal infections, meningitis and septicaemia caused by organisms sensitive to tobramycin.

It is important to note that this medication is only effective against bacterial infections - if your infection is the result of a viral or fungal infection, it will be ineffective.

Tobramycin has a very narrow margin of safety, meaning that the toxic concentration of this drug is only slightly higher than its therapeutic dose.

The toxicity of this, and other similar antibiotics, may have severe effects on the ears - this may include permanent hearing loss, balance disturbances and/or ringing in the ears. If used by injection, use should be reserved for severe infections and patients should be monitored closely, while treatment should be for as short a period as possible.

How does tobramycin work?

Tobramycin is part of the aminoglycoside group of bacteria. It kills bacteria as a result of abnormal protein production in the bacterial cell - it cannot produce any of its proteins correctly - and also as a result of damage to the bacterial cell membrane.

Fast facts

Drug schedule: schedule 4

Available as: tobramycin is available as injection and powder

What does it do? This medication has an antibiotic action.

Overdose risk: high

Dependence risk: low

Is tobramycin available as a generic? yes

Is tobramycin available on prescription only? yes

Special precautions

Consult your doctor before using this drug if:

  • you have a kidney disease
  • you have a hearing disorder
  • you have myasthenia gravis
  • you have Parkinson's disease
  • you are taking other medication

Pregnancy: a void. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: a void. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: t his medication is safe for use.

Infants and children: this medication should only be used as prescribed by a paediatrician.

The elderly: caution is advised in the elderly and a reduced dose may be needed.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

nausea and vomiting

x

x

local irritation/ stinging/ burning with local application

x

x

dizziness

x

x

vertigo

x

x

hearing loss/ visual disturbance

x

x

tremors

x

x

headache

x

x

muscle twitch

skin rash/ itchy skin

x

x

ringing in the ear

x

x

bloody or cloudy urine

x

x

Interactions

Drug interactions

amphoterecin b

increased risk of kidney toxicity

warfarin

increased risk of bleeding

biphosphonates

increased risk of low calcium levels

vancomycin/ aminoglycoside antibiotics

increased risk of hearing loss and kidney toxicity

oral contraceptives

risk of contraceptive failure

furosemide

increased risk of hearing loss

suxamethonium

risk of respiratory depression

neostigmine/pyridostigmine

reduced effect

Disease interactions

Consult your doctor before using this drug if you have a kidney or liver disease, you have a hearing disorder, you have myasthenia gravis, or if you have Parkinson's disease.

Recommended dosage

Adults: 5 - 6mg/kg given every 12 hours.

Children: only as prescribed by a paediatrician.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

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