📋 Indications & Clinical Dosage
*Bone & Joint infections, Lower Respiratory Tract Infections, Septicaemia, Meningitis and other CNS infections, Biliarytract infection, Acute pyelonephritis or prostatitis, Pneumonia in hospital patients:*
BY IM INJ, OR BY SLOW IV INJ, OR BY IV INF: Adult: 3 mg/kg daily in 3 divided doses; increased if necessary up to 5 mg/kg daily in 3-4 divided doses, increased dose used in severe infection; dose to be reduced back to 3 mg/kg daily as soon as clinically indicated.
*Urinary-tract infection:*
BY IM INJ: Adult: 2-3 mg/kg for 1 dose.
💊 Mode of Administration
Infuse over 30-60 min. Give penicillins or cephalosporins at least 1 hour apart from tobramycin. Standard diluent dose/100 ml NS; minimum volume, 50 ml NS
⚠️ Precautions & Warnings
To avoid excessive dosage in obese patients, use ideal weight for height to calculate dose and monitor serum amikacin concentration closely. Care must be taken with dosage, caution in conditions characterized by muscular weakness (aminoglycosides may impair neuromuscular transmission). Ensure adequate hydration; if possible, dehydration should be corrected before starting an aminoglycoside, if possible, parenteral treatment should not exceed 7 days, renal impairment, auditory, vestibular or neuromuscular dysfunction, haemoptysis. Monitor auditory and renal function during therapy.
🔄 Drug Interactions
Drugs with nephrotoxic or ototoxic potential, diu-retics, urea, anti cholinesterases, botulinum toxin.
⚠️ Adverse Reactions / Side Effects
Auditory damage, impaired neuromuscular transmission, irreversible ototoxicity, nephrotoxicity, transient myasthenic syndrome in patients with normal neuromuscular function with large doses given during surgery, vestibular damage. Rare: Antibiotic-associated colitis, electrolyte disturbances, hypocalcaemia, hypokalaemia, hypomagnesaemia on prolonged therapy, nausea, peripheral neuropathy, stomatitis, vomiting, Blood disorders, CNS effects, convulsions, encephalopathy, rash
🧪 Compatibility & Storage Stability
Compatibility: Stable in dextran 40 10% in dextrose, D5NS, D5W, 010W, mannitol 20%, LR, NS. Don't mix tobramycin in same solution with parenteral aminoglycosides or beta lac-tam antibiotics because mutual inactivation may occur.
Y-site administration: Seemdrug to drug compatibility chart
Stability & Storage: Stable at room temperature as the dry powder. Reconstituted solution remains stable for 24 hours at room temperature and 96 hours when refrigerated.