Tobramycin is indicated for the following infections caused by susceptible strains of bacteria-

• Septicemia
• Bronchitis
• Pneumonia
• Meningitis
• Gastrointestinal infections
• Bone infection
• Skin infection
• Urinary tract infection

Septicemia	Bronchitis	Pneumonia
Meningitis	Gastrointestinal Infection	Bone Infection

Tobramycin ophthalmic drops and ointment is indicated for-

Eye Infection

Intravenous infusion:

• Administration for Patients with Normal Renal Function:
  • Adults with Serious Infections 3 mg/kg/day in 3 equal doses every 8 hours.
• Adults with Life-Threatening Infections:
  Up to 5 mg/kg/day may be administered in 3 or 4 equal doses. The dosage should be reduced to 3 mg/kg/day as soon as clinically indicated. To prevent increased toxicity due to excessive blood levels, dosage should not exceed 5 mg/kg/day unless serum levels are monitored.
• Pediatric patients (greater than 1 week of age):
  6 to 7.5 mg/kg/day in 3 or 4 equally divided doses (2 to 2.5 mg/kg every 8 hours or 1.5 to 1.89 mg/kg every 6 hours).

Ophthalmic drops/ointments: 

• Drops: In mild to moderate infections, instill 1 or 2 drops every 4 hours into the infected eye(s). In severe infections, instill 2 drops per hour into the infected eye(s) until symptoms improve. 
• Ointments: Apply a small amount 2-3 times daily into the conjunctival sac if you have a mild to moderate infection (s).
  Apply a small amount 3-4 times daily into the conjunctival sac(s) in severe cases of infection until symptoms improve, then gradually reduce the dose.
• Dosage adjustment is required for renally impaired patients.

How to apply eye drops:

Eye Drops

How to apply eye ointment:

Eye Ointment

Tobramycin can cause the following side effects:

• Nephrotoxic
• Ototoxic
• Anemia
• Rash
• Fever
• thrombocytopenia
• Nausea
• Vomiting
• Confusion
• Eosinophilia

Nephrotoxicity	Anemia	Rash
Thrombocytopenia	Eosinophilia	Nausea

• Because tobramycin injection and other aminoglycosides have the potential to cause ototoxicity and nephrotoxicity, patients receiving these medications should be closely monitored.
• It is possible to develop neurotoxicity, which manifests as both auditory and vestibular ototoxicity. The changes in hearing are permanent, usually bilateral, and may be partial or complete.
• Patients with preexisting renal injury and those with normal renal function who are given aminoglycosides for longer periods of time or at higher doses than indicated may develop eighth-nerve impairment and nephrotoxicity.