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Aminoglycoside antibiotic

Tobramycin

Brand names: TOBI, Bramitob, Tobi Podhaler

Tobramycin is an aminoglycoside antibacterial used intravenously for serious Gram-negative infection, and given by nebuliser to suppress chronic Pseudomonas infection in cystic fibrosis and bronchiectasis.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION Tobramycin may be given intramuscularly or intravenously. Recommended dosages are the same for both routes. This insert is for a Pharmacy Bulk Package and is intended for preparing I.V. admixtures only. Dosage recommendations for intramuscular use are for informational purposes only. The patient’s pretreatment body weight should be obtained for calculation of correct dosage. It is desirable to measure both peak and trough serum concentrations (see WARNINGS box and PRECAUTIONS ). Administration for Patients with Normal Renal Function— Adults with Serious Infections : 3 mg/kg/day in 3 equal doses every 8 hours (see Table 3). Adults with Life-Threatening Infections : …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2023-02-27. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It binds the bacterial 30S ribosomal subunit, inhibiting protein synthesis and producing a concentration-dependent bactericidal effect, principally against aerobic Gram-negative organisms.

Prescribing in practice

  • Nephrotoxicity and ototoxicity (both auditory and vestibular, and potentially irreversible) are the key hazards, so therapeutic drug monitoring and renal monitoring are essential.
  • Avoid concurrent use with other nephrotoxic or ototoxic drugs wherever possible, and adjust dosing in renal impairment.
  • Use with caution in myasthenia gravis and other neuromuscular disorders, as aminoglycosides may impair neuromuscular transmission.

Monitoring

Monitor serum drug concentrations to guide dosing, together with renal function; assess auditory and vestibular function during prolonged courses and review hydration status. Limit the duration of treatment in keeping with antimicrobial stewardship.

Counselling the patient

  • Report any hearing loss, ringing in the ears, dizziness or unsteadiness without delay.
  • Report a marked reduction in urine output or new swelling.
  • Attend for the blood tests arranged to check drug levels and kidney function.

Evidence & guidelines

An established aminoglycoside in UK practice; dosing and monitoring should follow local antimicrobial guidance.

Reference: NICE NG78; UKHSA; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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