Formulary Monographs [TOBRAMYCIN, 081202]

Septicaemia and neonatal sepsis, biliary infections, endocarditis, acute pyelonephritis. Tobramycin is slightly more effective for Pseudomonas aeruginosa than gentamicin, but shows less activity against certain other Gram-negative bacteria. Tobramycin is
Nephrotoxicity and ototoxicity occur with high concentrations. It is less toxic than gentamicin. The dose should be reduced in renal failure and in the elderly. C.f. prescribing in renal disease p. 38.
Adult: 3-5mg/kg/day divided every 8 to 12 hours based on renal function and serum tobramy cin levels: or once-daily administration is
4-7mg/kg/day; higher doses may be needed depending on the diagnosis. Pediatric 1 mth- 12 yrs: 2-2.5mg/kg every 8 hours.
Risk of auditory or vestibular nerve damage in the infant when aminoglycosides are used in the second and third trimesters of pregnancy.The risk is probably very small with Tobramycin.