Aminoglycoside antibiotic
Tobramycin
Brand names: TOBI, Bramitob, Tobi Podhaler
Adult dose
Dose: IV: 5–7 mg/kg OD (extended-interval; trough <1 mg/L). Inhaled (CF): 300mg BD alternating 28-day cycles. Ophthalmic: 1-2 drops QDS
Route: IV/Inhaled/Topical
Frequency: OD (IV)
Dose adjustments
Renal
Reduce per CrCl; therapeutic monitoring
Clinical pearls
- CF Pseudomonas (inhaled), Gram-negative sepsis
- Trough <1 mg/L; once-daily preferred
Contraindications
- Hypersensitivity
- Severe renal impairment (caution)
- Myasthenia gravis
- Pregnancy (relative)
Side effects
- Nephrotoxicity
- Ototoxicity (vestibular & cochlear)
- Neuromuscular blockade
- Bronchospasm (inhaled)
Interactions
- Loop diuretics
- Other ototoxic/nephrotoxic drugs
- Neuromuscular blockers
Monitoring
- Drug levels
- U&E
- Audiometry
Reference: BNF; NICE NG78; UKHSA; https://bnf.nice.org.uk/drugs/tobramycin/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Centor / McIsaac Score for Strep Pharyngitis · Throat
- Ideal Body Weight (Devine) · Anthropometry
- FeverPAIN Score for Strep Throat · Throat
- Jarisch-Herxheimer Reaction Severity Assessment · Treatment Reactions
- PID Severity (CDC Diagnostic Criteria) · Gynaecological Infections
- Gustilo-Anderson Classification (Open Fractures) · Fracture Classification
Drugs
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023