Uses of Tobramycin

Drug Tobramy is an antibiotic drug used in cases of bacterial infections such as: respiratory tract infections, genital and urinary tract infections... The drug is prepared in many different forms to suit different patients. different infections.

Tobramycin is an aminoglycoside antibiotic. The drug has a bactericidal effect. Although the exact mechanism of action of the drug is not fully known, it has been hypothesized that it inhibits protein synthesis in susceptible bacteria by irreversibly binding to the subunits. 30S position of the ribosome.
Tobramycin is active against many aerobic Gram-negative bacteria and some aerobic Gram-positive bacteria. Tobramycin is not active against Chlamydia, fungi, viruses and most anaerobic bacteria.
The drug is prepared in many different forms, injectable with many strengths such as 20 mg / 2 ml, 25 mg / 2.5 ml, 60 mg / 6 ml, 80mg / 8 ml, 100 mg / 2 ml, 240 mg /6 ml, 1.2 g/30ml...;Prepared as an infusion of 60 mg/50 ml, 80 mg/100 ml; powder for injection; Mist solution; 0.3% tobramycin ophthalmic solution; Ophthalmic ointment 0.3%.
Thanks to its bactericidal effect, Tobramycin is widely indicated in cases of bacterial infections such as:
Infections of the genitourinary system - urinary tract. Septicemia, infective endocarditis. Meningitis: In addition to taking drugs, it is necessary to accompany local treatment measures. Lower respiratory tract infections, severe skin infections such as malignant staphylococcal infections of the face. Joint infection. For inhalation: Used exclusively for people with cystic fibrosis of the pancreas infected with Ps. aeruginosa and children ≥ 6 years old. Tobramycin can be used as tobramycin ophthalmic solution or 0.3% ophthalmic ointment for patients with ocular infections.

Some contraindications to Tobramycin antibiotics:
Hypersensitivity to tobramycin or to any component of the drug. For people with a history of allergy to aminoglycoside antibiotics, people with myasthenia gravis, people with hearing loss and kidney disease, caution should be exercised.

How to use Tobramycin antibiotic depends on each preparation and different disease cases.
Dosage:
Adults:
Usual dose: Use by intramuscular or intravenous injection or intravenous infusion at a dose of about 3 mg/kg/day, divided into 3 small doses every 8 hours or both. 1 time/day. If severe infection: As in the case of sepsis, at a dose of 5 mg/kg/day, divided into several small doses given every 6-8 hours, or can also be given once a day. Then, when a good response is obtained, it should be reduced to 3 mg/kg as soon as possible. Urinary tract infections: Intramuscular injection with a dose of 2-3 mg/kg/day, a single dose. Chronic pneumonia caused by Pseudomonas aeruginosa in people with cystic fibrosis of the pancreas: Inhalation of a nebulizer solution: 300 mg, 12 hours apart, for 28 days. The course of treatment is then repeated at 28-day intervals, that is, every 28 days off, and then again for 28 days. For inhaled powder form: Take 112 mg dose 12 hours apart for 28 days. The course of treatment is then repeated at 28-day intervals, that is, every 28 days off, and then again for 28 days. In case of eye infection: Use tobramycin eye ointment, 2-3 times a day for mild and moderate infections, or check every 3-4 hours until the disease improves and then reduce the number of visits. before discontinuing the drug, in case of severe infection. Or use tobramycin ophthalmic solution: Apply 1 drop to the conjunctiva every 4 hours for mild and moderate infections, for severe infections, apply 1 drop to the conjunctiva every 1 hour . Continue treatment until relief, then gradually reduce the number of visits. Before applying with ointment or solution, you need to clean your hands and carefully store the medicine to avoid the risk of infection. For children:
Neonatal sepsis : Administer intravenous infusion over 3 - 5 minutes 24 hours apart or intravenous infusion Infants under 7 days of age: dose 2 mg/kg, every 12 hour/time. Infants 7 to 28 days old: dose 2 - 2.5 mg/kg, every 8 hours. Septicemia, meningitis and other central nervous system infections, biliary tract infections, acute pyelonephritis, hospital-acquired pneumonia: For a single-day divided dose regimen, slow intravenous injection 3-5 minutes: For children from 1 to 12 months, the dose is 2-2.5mg/kg, every 8 hours; Children 12 to 18 years old use at a dose of 1 mg/kg, every 8 hours; For severe infections, use a maximum dose of 5 mg/kg/day, divided into several small doses, every 6-8 hours and reduce the dose as soon as possible. 1 dose/day regimen, intravenous infusion: Children 1 month - 18 years of age, the initial dose is 7 mg/kg, then adjust according to the serum concentration of tobramycin. For patients with renal failure: If using the usual regimen (multiple doses/day):
Creatinine clearance ≥ 60 ml/min, dose every 8 hours. Creatinine clearance 40 - 60 ml/min, administered every 12 hours. Creatinine clearance 20-40 ml/min, administered every 24 hours. Creatinine clearance 10-20 ml/min, administered every 48 hours. Creatinine clearance < 10 ml/min, administered every 72 hours. The high-dose regimen is administered every 48 hours for patients with renal failure with a creatinine clearance of 30 - 59 ml/min and then the dose is adjusted depending on the serum drug concentration.

Like other drugs, when you take Tobramycin, you may also experience some side effects.
Common side effects: when used in inhalation or as a supplement, it can cause sputum to change color, cough, change voice; Chest discomfort; Abnormal taste changes, dry mouth. The injection route causes pain at the injection site, which can cause diarrhea, nausea, and vomiting. Uncommon side effects; Hypersensitivity reactions, urticaria, pruritus, decreased exercise capacity; Loss of voice, increased secretion of bronchial mucus; disorders of the airways due to obstruction; risk of lower respiratory tract infections, pneumonia, pulmonary congestion, abnormal breathing sounds, nasal congestion; Decreased sensation in the mouth, Candida infection in the mouth; Hearing damage causing deafness; Chest musculoskeletal pain; Increased serum glucose. Rare side effects: electrolyte disturbances causing decreased serum calcium, magnesium, sodium and potassium; Confusion, disorientation, dizziness, fever, headache, excessive sleep, dizziness; exfoliative dermatitis ;Anemia, causing eosinophilia, agranulocytosis, thrombocytopenia; Increased liver enzymes, increased bilirubin, increased LDH; Hearing ability, tinnitus; Urinary cast, increased BUN, increased serum creatinine, proteinuria. It is necessary to notify the doctor when experiencing side effects so that they can be consulted and supported promptly.

It is necessary to inform the doctor about the history of allergies, the drugs you are taking or any medical conditions you are experiencing, the drugs you are taking.
Side effects of aminoglycoside drugs (including tobramycin) are often dose related, so the correct dose should be used with caution, parenteral therapy should not exceed 7 days.
Monitor the concentration of drugs in the blood in necessary cases. Renal function should be assessed before taking the drug, if dehydration needs to be treated before starting the drug.
Extreme caution must be exercised with aminoglycosides in the elderly because the risk of ototoxicity and renal toxicity is most common in this population. Sometimes it is necessary to reduce the dose.
Aminoglycosides such as Tobramycin should be used with caution when administered to patients with muscle disorders, such as patients with myasthenia gravis or Parkinson's disease.
Hearing, vestibular function and renal function should be monitored in patients with known or suspected renal impairment. Cross-allergies have been observed when using this drug with other aminoglycosides, so if you have a history of hypersensitivity to drugs in the same class, it is best not to use it.
Note when used in special cases: Newborns should only use tobramycin when they have serious life-threatening illnesses; For pregnant women, Tobramycin concentrates on the fetal kidneys and has been shown to cause irreversible deafness in both ears. Therefore, the benefits and risks must be weighed very carefully when this drug must be used in life-threatening conditions or in severely ill patients for which other drugs are ineffective or ineffective; For women who are breast-feeding, Tobramycin is excreted in breast milk, so it is not recommended to use it while breastfeeding, or preferably not to breast-feed while taking the drug. Although there is little risk of harm to a nursing infant, as long as it is safe for your baby do not breast-feed while taking this medicine.
Overdosage may result in increased toxicity, especially renal damage (acute renal cell necrosis, usually reversible), ototoxicity (usually irreversible) and vestibular toxicity (eg. irreversible damage). As there is no specific antidote for this drug, treatment of an overdose or toxic reaction of tobramycin is mainly aimed at symptomatic relief.
Drug interactions can occur when used concurrently with other drugs.
Concomitant use of other potentially neurotoxic or nephrotoxic drugs, especially other aminoglycosides such as Amikacin, streptomycin, neomycin, kanamycin, gentamicin and paromomycin... quite similar to amphotericin B, cephaloridine , polymyxin B, colistin, viomycin, cisplatin and vancomycin should be carefully monitored. Tobramycin should not be used concomitantly with potent diuretics. Because some diuretics themselves cause ototoxicity, diuretics also increase aminoglycoside toxicity by altering the antibiotic serum and tissue concentrations. Combination with other antibiotics: Tobramycin is used with other antibacterial agents such as cephalosporins, especially cephalothin, there is an increased risk of nephrotoxicity. Muscle relaxants: Increased risk of respiratory muscle paralysis when combined with muscle relaxants. Medicines are used only as prescribed by the doctor, not self-administered. Tobramycin eye drops should only be used for bacterial infections, viral or allergic infections should not be used. Do not use the medicine after the expiration date and when there are signs of damage. When using tobramycin eye drops, make sure to keep the tip clean and close the cap tightly after use, to avoid the risk of infection. Above is information about the use, how to use and note when using the drug. In any case, you need to consult a doctor to ensure the safety and effectiveness of taking the drug.