Tobramycin
Tobramycin is an aminoglycoside antibacterial.
Group
Aminoglycoside antibacterial
Mechanism of Action
Binds bacterial 30S ribosomes, disrupts protein synthesis and is rapidly bactericidal.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Systemic bacterial infection | 9–14 mg/kg | SC, IM, IV | Every 24 h | |
| Systemic bacterial infection divided-dose alternative | 2 mg/kg | IV, IM, SC | Every 8 h | Older divided schedule; once-daily exposure and therapeutic monitoring may be preferred. |
| Urinary bacterial infection | 1–2 mg/kg | SC | Every 8 h | |
| Sepsis | 2–4 mg/kg | IV | Every 8 h | |
| Soft tissue or systemic infection | 1–1.7 mg/kg | IV | Every 8 h | Up to 7 days; Therapeutic drug and renal monitoring; source courses no more than about 7 days. |
| Soft tissue or systemic infection | 3–5.1 mg/kg | IV | Every 24 h | Up to 7 days; Therapeutic drug and renal monitoring; source courses no more than about 7 days. |
| Systemic infection | 2 mg/kg | SC | Every 8–12 h | Up to 7 days; Therapeutic drug and renal monitoring; source courses no more than about 7 days. |
| Systemic infection | 4–6 mg/kg | SC | Every 24 h | Up to 7 days; Therapeutic drug and renal monitoring; source courses no more than about 7 days. |
| Persistent bacteremia | 3–5 mg/kg | IV, IM, SC | Every 8 h | Up to 7 days; Therapeutic drug and renal monitoring; source courses no more than about 7 days. |
| Persistent bacteremia | 9–15 mg/kg | IV, IM, SC | Every 24 h | Up to 7 days; Therapeutic drug and renal monitoring; source courses no more than about 7 days. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Systemic bacterial infection | 5–8 mg/kg | SC, IM, IV | Every 24 h | |
| Systemic bacterial infection divided-dose alternative | 2 mg/kg | IV, IM, SC | Every 8 h | Older divided schedule; once-daily exposure and therapeutic monitoring may be preferred. |
| Urinary bacterial infection | 1–2 mg/kg | SC | Every 8 h | |
| Sepsis | 2–4 mg/kg | IV | Every 8 h | |
| Soft tissue or systemic infection | 2 mg/kg | IV, IM, SC | Every 12 h | Up to 5 days |
| Soft tissue or systemic infection | 4 mg/kg | IV, IM, SC | Every 24 h | Up to 5 days |
| Persistent bacteremia | 2 mg/kg | IV, IM, SC | Every 8 h | Up to 5 days |
| Persistent bacteremia | 6 mg/kg | IV, IM, SC | Every 24 h | Up to 5 days |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Systemic bacterial infection | 4 mg/kg | IV, IM | Every 24 h | Reported target for many susceptible organisms. |
| Higher-MIC bacterial infection | 7.2 mg/kg | IV, IM | Every 24 h | Reported exposure target for organisms with MIC 4 mcg/mL. |
Llamas
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Susceptible infection | 4 mg/kg | IV | Every 24 h | |
| Susceptible infection | 0.75 mg/kg | IV | Every 8 h |
Birds
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Susceptible infection | 5 mg/kg | IM | Every 12 h |
Reptiles
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Susceptible infection | 2.5 mg/kg | IM | Every 24 h |
Indications
- Serious susceptible gram-negative infections
- Systemic bacterial infection divided-dose alternative
- Urinary bacterial infection
- Sepsis
- Soft tissue or systemic infection
- Systemic infection
- Persistent bacteremia
- Susceptible infection
Contraindications
- Renal disease
- Neuromuscular blockade risk with anesthetics.
Interactions
- Do not mix with other antibiotics, particularly beta-lactams, in syringes or infusion containers.
Adverse effects
- Nephrotoxicity, ototoxicity and vestibular toxicity.
Toxicity
Overexposure increases renal and auditory/vestibular injury risk. Monitor serum drug concentration and renal function; dialysis can remove drug in severe selected cases.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Tobramycin injection 40 mg/mL | Injection | 40 mg / mL | SC, IM, IV |
| Tobi nebulizer solution 60 mg/mL Preservative-free nebulization presentation; veterinary numeric regimen unestablished. | Other | 60 mg / mL | INHALATION |
Monitoring and Administration
Maintain hydration and monitor BUN, creatinine and urinalysis. For once-daily dosing, trough should be below assay detection; clearance estimates can guide dosing.
Nebulized animal doses are not established; human nebulization amounts are not animal regimens. Reconstituted solution stability described as 24 hours ambient or 96 hours refrigerated; discard discoloration.