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.
aminoglycoside antibiotic
Like other aminoglycosides, the bactericidal activity of Tobramycin is taken up into sensitive bacterial cells by an active transport process. Within the cell Tobramycin bind to the 30s, and to some extent to the 50s subunits of the bacterial ribosome, inhibiting protein synthesis and generating errors in the transcription of the genetic code. The manner in which cell death is brought about is imperfectly understood, and other mechanisms may contribute, including effects on membrane permeability.
OPHTHALMIC Ocular infections: Adult: As 0.3% eye drop: Mild to moderate infections: Instill 1-2 drops into affected eye every 4 hr. Severe infections: Instill 2 drops into affected eye every 30-60 mins initially until improvement, reduce treatment frequency before discontinuation. As 0.3% eye ointment: Mild to moderate infections: Apply a half-inch ribbon bid-tid into affected eye. Severe infections: Apply a half-inch ribbon into the affected eye every 3-4 hr until improvement, reduce treatment frequency before discontinuation.
Care should be exercised when tobramycin is given to patients receiving other drugs with neuromauscular blocking agents or ototoxic.
Hypersensitivity to aminoglycosides; pregnancy. Preexisting renal & auditory or vestibular impairment; dehydration; neuromuscular blockade, muscular disorders (e.g. myasthenia gravis, parkinsonism); neonates; elderly; lactation. Avoid peak plasma concentrations > 10 mcg/ml or trough concentrations >2 mcg/ml when used parenterally.
Nausea, vomiting, dizziness or vertigo, acute renal failure, interstitial nephritis, acute tubular necrosis, electrolyte imbalances, purpura, encephalopathy, convulsions, mental depression, hallucinations, ototoxicity, blood dyscrasias, increased LFT & bilirubin concentrations. Topical: Ocular toxicity & hypersensitivity reactions (e.g. itching & oedema of the eyelid), conjunctival erythema, punctate keratitis & tearing. Neuromuscular blockade, resp paralysis, anaphylaxis.
This drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus. Use is not recommended and a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.
Sign and symptoms of overdose may be similar to side effects as described above.
Protect from light, store in cool (below 25°C) & dry place. Keep out of reach of children. Used within 4 weeks after first opening.
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